Prevalence and risk factors of depression in the elderly nursing home residents in Singapore

Abstract

Objectives: Depression is a common health problem in elderly nursing home (NH) residents and is often under-recognized and under-treated. This study aimed to determine the prevalence rates of depression and identify the risk factors associated with depression in the elderly NH population in Singapore.

Methods: A sample of 375 residents in six NHs in Singapore, aged 55 years and above, was assessed with the Structural Clinical Interview (SCID), based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria. The association of demographic, functional and health-related characteristics with depression was examined using multivariate logistic regression analyses.

Results: Overall point prevalence for depression in the elderly NH residents was found to be 21.1% (95% confidence intervals (CI): 17.1%–25.6%). The prevalence rate for minor depression in the elderly NH residents was 14.4% (95% CI: 11.1%–18.5%) and 6.7% (95% CI: 4.5%–9.8%) for major depression. Significant risk factors that were found to be associated with depression were length of stay for more than 2 years, known history of depression, pain, and no or lack of social contact.

Conclusion: The prevalence rates for depression were high among NH residents in Singapore. More attention is needed to care for the psychosocial needs of elderly NH residents in Singapore.

Keywords:

• depression
• prevalence
• risk factors
• elderly nursing home residents

Acknowledgements

We wish to thank the fourth-year medical students from the National University of Singapore, Yong Loo Lin School of Medicine for conducting the fieldwork, and the National University of Singapore for funding the study.

Notes

Chronic conditions included anaemia, asthma/COPD, cancer, constipation, diabetes mellitus, end-stage renal failure, fall-related fractures, gastrointestinal tract pathology, heart disease, hyperlipidaemia, hypertension, incontinence, nephropathy, osteoarthritis, pressure ulcer, schizophrenia, stroke and visual impairment.

ADL: activities of daily living; AMT: abbreviated mental test.

The differences in the age- and gender-specific prevalence rates for both minor and major depression were not statistically significant.

Depression included both major and minor depression. OR: odds ratio; CI: confidence interval.

Backward and forward strategies pointed to the same solution in the multivariate logistic regression analysis.

Variables included in the multivariate model were those exhibited statistical significance in the bivariate analysis. *Not statistically significant.