Depressive Disorders in Older People

Thursday, 25 July 2013: 8:30 AM

Joao Luis Apostolo, RN, MS, PhD
Health Sciences Research Unit: Nursing, Coimbra Nursing School, Coimbra, Portugal

Learning Objective 1: The learner will be able to identify the prevalence of depressive disorders in community-dwelling and nursing home older people.

Learning Objective 2: The learner will be able to identify different depressive disorders according to older people’s gender and residence.

Purpose: To describe depressive disorders and the use of antidepressant medication in community- dwelling and nursing home older people; and to analyze different depressive disorders according to older people’s gender and residence.

Methods: The Portuguese version of the Geriatric Depression Scale - GDS-15 - (Apóstolo, 2011) was administered by interview to 346 older people from Central and Northern Portugal, community-dwelling (n = 188), or institutionalized in three nursing homes (n = 158). The sample included 61.99% women and 38.01% men; mean age 77.52 years, SD 7.89 years; 7.58% single, 42.85% married, 20.12% divorced and 29.45% widowed. As for the level of education, 75.80% had between 0 and 4 years of education, 17.79% between 6 and 12, and 6.41% had more than 12 years.

Results: In this sample, 46.83% of women and 26.68% of men reported history of depression; 27.40% of women and 14.84% of men reported taking antidepressant medication. The sample included 64.46% of women and 47.69% of men classified as having depressive disorder, as well as 54.79% of community-dwelling elders and 63.29% of nursing home residents. The t-test for independent samples showed that women have higher levels of depressive disorders (mean=7.59) than men (mean=6.12) (t = 3.310, p = 0.001), and that community-dwelling elders have lower levels (mean=6.56) than nursing home elders (mean=7.69) (t = -2.56, p = 0.011).

Conclusion: Results show that a high percentage of older people use antidepressant medication and are classified as having depressive disorder. Women and nursing home residents present high levels of depressive disorders. As a mental disorder, depression is under-recognized among the elderly, with major negative consequences. Thus, we propose an improvement of the assessment and intervention processes by introducing, in different contexts, a screening instrument, such as the GDS-15, and health promotion and education strategies with a special focus on the use of antidepressant medication.