Physical morbidity pattern and presence of depression among geriatric population in a rural area of Bangladesh

INTRODUCTION:  Bangladesh is one of the twenty countries in the world with the largest elderly population. Ageing is gradually emerging as an important concern in terms of social and health related planning and policies.

METHODS: A community based cross sectional study was conducted to study physical morbidity pattern and presence of depression among 669 randomly selected rural elderly people, aged > 60 years. Data collected through face-to-face interview and document review. Depressive symptoms were measured using Geriatric Depression Scale-30 at cut off value 10-19 for mild depression and >20 for severe depression.

RESULTS: Physical morbidity were present in 88.8% of study population with multimorbidity in 57.1% and average illness 1.87 per person. Most common physical illness was osteoarthritis, followed by hypertension, peptic ulcer disease, cataract, deafness and diabetes mellitus. Most common presenting symptom was impaired vision, followed by joint pain, weakness, body ache, impaired memory and poor appetite. Musculoskeletal system was most commonly involved, followed by cardiovascular system, gastrointestinal tract and eye problems. Depressive symptoms were detected in 68.2% of elderly which included 31.5% with severe depression. Higher educational status of the respondent and higher family income identified as best protectors against depression. Female sex (CI 1.83-3.57), absence of spouse (CI 1.61-3.37), inability to work (CI 1.27-2.43), absence of personal source of income (CI 1.37-2.75), dependence on others (CI 1.65-3.46), staying in nuclear families (CI 1.0-1.99) and co-morbid physical illness (CI 1.76-3.31) were important predictors for depressive symptoms.

CONCLUSIONS: The study highlighted a high prevalence of physical morbidity and depression in geriatric population. Important association found between presence of old age depression and several sociodemographic factors. These findings demand specific plan to strengthen geriatric health care services, social and economic support for elderly population & proper development, analysis and implementation of geriatric related policies by government and non-government organizations.