Depression among older people in Bali

Abstract

Introduction. Depression is the most common mental disorder. Older adults are more vulnerable to depression and are usually underdiagnosed and untreated. This study aims to determine the prevalence of depression among older adults in Bali and identify its risk factors. Methods. This study used data from the Dementia Study in Bali 2018. Depression was assessed using a short version of the Center for Epidemiologic Studies Depression (CES-D) scale. Scores of ≥10 were categorised as depression and <10 no depression. Risk factors included age, sex, marital status, educational level, employment status, residential district, urban status, economic status, household members, social participation, hobby activities, activities of daily living (ADL), instrumental activities of daily living (IADL), and comorbidities. Older adults with and without depression were compared to determine any risk factors. Multivariate logit regression was used to determine the association between risk factors and depression. Results. A total of 774 female and 719 male participants aged 60 to 100 (mean, 70±7.3) years were included. The mean CES-D score was 9.04±5.92 (range, 0-30). Using the cut-off CES-D score of ≥10 as depression, 631 (42.3%) participants were considered depressed. The prevalence of depression was similar between male and female participants and increased with age. Among female older adults, depression was associated with being married (odds ratio [OR]=1.53, p=0.019), ADL dependent (OR=2.58, p=0.002), IADL dependent (OR=1.93, p=0.033), having high comorbidity scores (OR=3.53, p=0.000), and residing in low socioeconomic districts (OR=2.53, p=0.026). Whereas having a household member aged 0-5 years (OR=0.570, p=0.013) and being active in a hobby (OR=0.339, p<0.001) were associated with lower likelihood of depression. Conclusion. The prevalence of depression among older adults in Bali was high (42.3%) and increased with age. Female older adults were more likely to be depressed when they were married, ADL and IADL dependent, and had comorbidity scores of 3-4 and ≥5. Having a grandchild in the household and active participation in hobbies were associated with lower risk of depression.