Prevalence of Depression among Iranian Elderly: A Systematic Review and Meta-analysis of Observational Studies

Document Type : Review

Authors

1 Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran

2 Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran

3 Be’sat Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran

4 Spiritual Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran

5 Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran

6 Department of Mathematics, Shahrood University of Technology, Shahrood, Iran

7 Lecturer in Pharmacoepidemiology and Pharmacy Practice, Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde, Glasgow, UK

Abstract

Background: Depression is a common mental disorder that affects a significant portion of older adults. In Iran, there is limited information on the prevalence of depression among this population. This systematic review and meta-analysis aimed to determine the pooled prevalence of depression among Iranian elderly individuals.
Objectives: To conduct a systematic review and meta-analysis of observational studies examining the prevalence of depression among Iranian elderly people.
Methods: We searched various electronic databases, including SID, MagIran, PubMed, Scopus, ScienceDirect, Web of Science, and Google Scholar, for articles published from January 2000 to December 2022. The keywords "senile depression," "geriatric depression," "elderly," "depression," "depressive disorder," and "Iran" or any combination of these terms were used. Two writers worked separately on data extraction and quality evaluation.
Results: Twenty-four studies met our inclusion criteria, yielding an overall prevalence rate of depression among Iranian elderly individuals of 53.7% (95% CI: 43.1-64.4). Gender subgroup analysis revealed that the prevalence of depression was significantly higher in women (50%, 95% CI: 42.3-69.7) compared to men (42.2%, 95% CI: 28.2-56.3). Furthermore, we found a statistically significant association between the sample size of the studies and the prevalence of depression (p = 0.009).
Conclusion: Our study suggests that depression is a major public health concern among Iranian elderly individuals. These findings underscore the need for further research into the underlying factors contributing to depression in this population and the development of effective interventions to address it.

Keywords


  1. Arslantas D, Ünsal A, Ozbabalık D. Prevalence of depression and associated risk factors among the elderly in Middle Anatolia, Turkey. Geriatr Gerontol Int. 2014;14(1):100-8. doi:10.1111/ggi.12065 PMid:23581512
  2. Ghanei Gheshlagh R, Frajzadeh M, Moslemi B, Karami M, Sarokhani M, Zarei M, et al. Studying the relation between quality of life and mental distresses among Kurd seniors living in Saghez, Iran. Nurs Pract Today. 2017;3(2):57-62.
  3. Hassanpour-Dehkordi A, Jalali A. Effect of progressive muscle relaxation on the fatigue and quality of life among Iranian aging persons. Acta Med Iran. 2016:430-6.
  4. Takeda M, Tanaka T. Depression in the elderly. Geriatr Gerontol 2010;10(4):277-9. doi:10.1111/j.447-0594.2010.00644.x. PMid:20887624
  5. Dorow M, Stein J, Pabst A, Weyerer S, Werle J, Maier W, et al. Categorical and dimensional perspectives on depression in elderly primary care patients-Results of the AgeMooDe study. Int J Methods Psychiatr Res. 2018;27:e1577. doi:10.1002/mpr.1577 PMid:28948667 PMCid:PMC6877261
  6. Sarokhani D, Parvareh M, Dehkordi AH, Sayehmiri K, Moghimbeigi Prevalence of depression among iranian elderly: systematic review and meta-analysis. Iran J Psychiatry. 2018; 13 (1): 55-64.
  7. Cole MG, Bellavance F, Mansour A. Prognosis of depression in elderly community and primary care populations: a systematic review and meta-analysis. Am J Psychiatry. 1999;156(8):1182-9.
  8. Li J, Theng Y-L, Foo S. Depression and psychosocial risk factors among community-dwelling older adults in Singapore. J Cross-Cultural Gerontol. 2015;30(4):409-22.
    doi:10.1007/s10823-015-9272-y PMid:26428668
  9. Rodda J, Walker Z, Carter J. Depression in older adults. BMJ-Br Med J. 2011;343(8):d5219. doi:10.1136/bmj.d5219. PMid:21957206
  10. Udayar SE, Prasad DV. Epidemiological study of socio demographic factors in relation to depression among the elderly people in a rural area of Chittoor district of Andhra Pradesh, India. Int J Commun Med Public Health. 2017;3(1):161-5. doi:10.18203/2394-6040.ijcmph20151554.
  11. Ghanei Gheshlagh R, Parizad N, Sayehmiri K. The Relationship Between Depression and Metabolic Syndrome: Systematic Review and Meta-Analysis Study. Iran Red Crescent Med J. 2016;18(6):1-6. doi:10.5812/ircmj.26523
  12. Unützer J, Patrick DL, Simon G, Grembowski D, Walker E, Rutter C, et al. Depressive symptoms and the cost of health services in HMO patients aged 65 years and older: a 4-year prospective study. JAMA. 1997;277(20):1618-23.
    doi:10.1001/jama.1997.03540440052032 PMid:9168292
  13. Cindy W, Helen F. Depression and Suicide in the Elderly. Med Bull. 2011;9(16):13-6.
  14. Davoodi F EK, Taheri Tanjani P, Khodakarim S. The Relationship between Depression and Cognitive Impairment with Falls Leading to Fractures in Elderly. J Saf Promot Inj Prev. 2017; 4(2):75-82.
  15. Mokhber N, Majdi M, Ali-Abadi M, Shakeri M, Kimiagar M, Salek R, et al. Association between malnutrition and depression in elderly people in Razavi Khorasan: a population based-study in Iran. Iran J Public Health. 2011;40(2):67-74. PMID: 23113074
  16. Mirzaei M, Sahaf R, Mirzaei S, Sepahvand E, Pakdel A, Shemshadi H. Depression and Its Associated Factors in Elderly Nursing Home Residents: A Screening Study in Khorramabad. Iran J Ageing. 2015;10(1):51-7.
  17. Nazemi L, Skoog I, Karlsson I, Hosseini S, Hosseini M, Hosseinzadeh MJ, et al. Depression, prevalence and some risk factors in elderly nursing homes in Tehran, Iran. Iran J Public Health. 2013;42(6):559-569. PMID: 23967423
  18. Shams A, Poor Hadi S, Sahaf R. Comparing Levels of Depression in Healthy Active and Inactive Elders versus Those with Knee Osteoarthritis Disease. Ann Appl Sport Sci. 2016;4(1):49-56. doi: 10.7508/aass.2016.01.008
  19. Gheshlagh RG, Ebadi A, Dalvandi A, Rezaei M, Nourozi Tabrizi K. A Systematic Study of Resilience in Patients with Chronic Physical Diseases. Nurs Midwifery Stud. 2017; 6 (2): 1-8. doi:10.5812/nmsjournal.36401
  20. Tsimicalis A, Stinson J, Stevens B. Quality of life of children following bone marrow transplantation: critical review of the research literature. Eur J Oncol Nurs. 2005;9(3):218-38. doi:10.1016/j.ejon.2004.08.006 PMid:16112524
  21. Cochran WG. The combination of estimates from different experiments. Biometrics. 1954;10(1):101-29. doi:10.2307/3001666
  22. Higgins JP, Thompson SG. Quantifying heterogeneity in a meta‐ Stat Med. 2002;21(11):1539-58. doi:10.1002/sim.1186 PMid:12111919                 
  23. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264-9. doi:10.7326/0003-4819-151-4-200908180-00135PMid:19622511
  24. Khalili Z, Taghadosi M, Heravi-Karimooi M, Sadrollahi A, Gilasi H. Assessment of the Associations of Depression with Elder Abuse Among the Elderly in Kashan City, Iran. Iranian J Ageing. 2016;10(4):8-17.
  25. Taheri Tanjanai P, Moradinazar M, Najafi F. Prevalence of depression and related social and physical factors amongst the Iranian elderly population in 2012. Geriatr Gerontol Int. 2017;17(1):126-31.doi:10.1111/ggi.12680 PMid:26818138
  26. Keshavarzi S, Ahmadi SM, Lankarani KB. The impact of depression and malnutrition on health-related quality of life among the elderly Iranians. Glob J Health Sci. 2015;7(3):161-170. doi: 10.5539/gjhs.v7n3p161
  27. Kheirkhah F, Hosseini SR, Hosseini SF, Ghasemi N, Bijani A, Cumming RG. Relationship between testosterone levels and depressive symptoms in older men in Amirkola, Iran. Caspian J Intern Med. 2014;5(2):65-70.
  28. Payahoo L, Khaje-Bishak Y, Gargari BP, Kabir-Alavi M-B, AsghariJafarabadi Assessment of nutritional and depression status in free-living elderly in Tabriz, Northwest Iran. Health Promot Perspect. 2013;3(2):288-293.
    doi:10.18869/acadpub.aums.2.1.7
  29. Ghaderi S, Sahaf R, Mohammadi Shahbalaghi F, Ansari G, Gharanjic A, Ashrafi K, et al. Prevalence of Depression in Elderly Kurdish Community Residing in Boukan, Iran. Salmand. 2012; 7(1):57-66.
  30. Ahmadi SM, Mohammadi MR, Mostafavi S-A, Keshavarzi S, Kooshesh S-M-A, Joulaei H, et al. Dependence of the geriatric depression on nutritional status and anthropometric indices in elderly population. Iran J Psychiatry. 2013;8(2):92-96. PMID: 24130608
  31. Gharanjik A MSF, Ansari G, Najafi F, Ghaderi S, Ashrafi K, et al. The Prevalence of Depression in Older Turkmen Adults in 1389. Salmand. 2011;6(3):34-9.
  32. Majdi MR, Ghayour Mobarhan M, Salek M, Taghi M, Mokhber N. Prevalence of depression in an elderly population: A population-based study in Iran. Iran J Psychiatry Behav Sci. 2011;5(1):17-24.
  33. Manzouri L BA, Merasi M. The Depression Status of the Elderly and It's Related Factors in Isfahan in 2007. Salmand. 2010; 4 (4): 27-34.
  34. Sadeghi M, M B. The Relationship between Depression and Quality of Life among Elderly of Nursing Home Residents and Non-Residents in Shahroud City. J Knowl Health. 2017; 12 (1): 8-15.
  35. Hatam B, Hamzeh R, Amir T. Evaluation of Prevalence of Geriatric Depression among Elderly Patients Admitted to non-Psychiatric Wards of Golestan and Imam Khomeini Hospitals in Ahwaz. Int J Pharma Res Health Sci. 2017;5(2):1664-7.
  36. Ashrafi K, Sahaf R, Farhadi A, Ansari G, Najafi F, Gharanjik A, et al. Prevalence of depression in turk azeri older adults of Iran. J Sabzevar Univ Med Sci. 2017;23(6):856-65. doi:10.21859/sums-2306856
  37. Arsalani N, Nobahar M, Ghorbani R, Kia NS, Etemadi M. Nutrition status and its relationship with depression in elderly pepople. Koomesh. 2017:401-11.
  38. Ahmadi Ahangar A, Hosseini SR, Kheirkhah F, Karimi M, Saadat P, Bijani A, et al. Association between Chronic Pain and Depression among the Elderly of Amirkola City, Northern Iran. Elderly Health J. 2017;3(2):74-9.
  39. Fukunaga R, Abe Y, Nakagawa Y, Koyama A, Fujise N, Ikeda M. Living alone is associated with depression among the elderly in a rural community in Japan. Psychogeriatrics. 2012;12(3):179-85. doi:10.1111/j.1479-8301.2012.00402.x PMid:22994616
  40. Kim J-I, Choe M-A, Chae YR. Prevalence and predictors of geriatric depression in community-dwelling elderly. Asian Nurs Res. 2009; 3 (3): 121-9. doi: 10.1016/S1976-1317(09)60023-2
  41. Cole MG, Dendukuri N. Risk factors for depression among elderly community subjects: a systematic review and meta-analysis. Am J Psychiatry. 2003;160(6):1147-56. doi:10.1176/appi.ajp.160.6.1147 PMid:12777274
  42. Seedat S, Scott KM, Angermeyer MC, Berglund P, Bromet EJ, Brugha TS, et al. Cross-national associations between gender and mental disorders in the World Health Organization World Mental Health Surveys. Arch Gen Psychiatry. 2009;66(7):785-95. doi:10.1001/archgenpsychiatry.2009.36 PMid:19581570 PMCid:PMC2810067
  43. Wang J-K, Su T-P, Chou P. Sex differences in prevalence and risk indicators of geriatric depression: the Shih-Pai community-based survey. J Formos Med Assoc. 2010;109(5):345-53. doi:10.1016/S0929-6646(10)60062-9
  44. Carayanni V, Stylianopoulou C, Koulierakis G, Babatsikou F, Koutis C. Sex differences in depression among older adults: are older women more vulnerable than men in social risk factors? The case of open care centers for older people in Greece. Eur J Ageing. 2012;9(2): 177-86. doi:10.1007/s10433-012-0216-x PMid:28804418 PMCid:PMC5547401
  45. Rajabizadeh G, Ramezani A. Prevalence of depression in Kermanian geriatrics-2002 J Rafsanjan Univ Med Sci. 2004; 3(1): 58-66.
  46. Yunming L, Changsheng C, Haibo T, Wenjun C, Shanhong F, Yan M, et al. Prevalence and risk factors for depression in older people in Xi′ an China: a community‐based study. Int J Geriatr Psychiatry. 2012;27(1):31-9. doi:10.1002/gps.2685 PMid:21284042
  47. Volkert J, Schulz H, Härter M, Wlodarczyk O, Andreas S. The prevalence of mental disorders in older people in Western countries-a meta-analysis. Ageing Res Rev. 2013;12(1):339-53. doi:10.1016/j.arr.2012.09.004 PMid:23000171
  48. Ranjan S, Bhattarai A, Dutta M. Prevalence of depression among elderly people living in old age home in the capital city Kathmandu. Health Renaiss. 2014;11(3):213-8. doi:10.3126/hren.v11i3.9634
  49. Girma M, Hailu M, Wakwoya A, Yohannis Z, Ebrahim J. Geriatric Depression in Ethiopia: Prevalence and Associated Factors. J Psychiatry. 2016;20(400):2-7. doi:10.4172/2378-5756.1000400