A Study of Depressive State and Background Factors in Community-Dwelling Older Persons.

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  • Kawamoto Ryuichi
    Department of Internal Medicine, Nomura Municipal Hospital Department of Community and Family Medicine, Jichi Medical School
  • Doi Takaaki
    Department of Internal Medicine, Nomura Municipal Hospital
  • Yamada Akihiro
    Department of Internal Medicine, Nomura Municipal Hospital
  • Oguni Takashi
    Department of Internal Medicine, Nomura Municipal Hospital
  • Okayama Masanobu
    Department of Community and Family Medicine, Jichi Medical School
  • Tsuruoka Kouki
    Department of Community and Family Medicine, Jichi Medical School
  • Satho Motomi
    Department of Internal Medicine, Fujisawa Municipal Hospital
  • Kajii Eiji
    Department of Community and Family Medicine, Jichi Medical School

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Other Title
  • 山間地域に在住する高齢者の抑うつ状態と背景因子に関する研究
  • サンカン チイキ ニ ザイジュウ スル コウレイシャ ノ ヨクウツ ジョウタイ ト ハイケイ インシ ニ カンスル ケンキュウ

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Abstract

In order to maintain and improve the mental health of elderly people living in the community, a cross-sectional survey was conducted to elucidate their depressive state and its background factors. Subjects were elderly persons living in the community who were able to fill in the questionnaire themselves. The study used the self recording questionnaire sheets used in the Kahoku Longitudinal Aging Study by Matsubayashi et al and the Zung Self-rating Depression Scale (SDS). Out of 2, 379 elderly persons who were able to fill in the questionnaire by themselves in the community, 2, 361 (99.2%) returned the questionnaire sheets. After removing inadequate responses, analysis was possible for 1, 181 (49.6%) (542 males (average age 72.3±5.5) and 639 females (average age 73.0±6.3). Degree of depressive state as evaluated by SDS was normal for 731 persons (61.9%); mild, 240 (20.3%); moderate, 181 (15.3%); and severe, 29 (2.5%). The average age became higher as the SDS became high, of being indicating the seriousness of the depressive state (p=0.0155), with the ratio women significantly higher (p=0.0077). Among those with severe SDS, the ratio of single persons was high (p<0.001) as well as those who were non-drinkers (p=0.0015), without regular habit of walking (p<0.001), or without work (p<0.001). The ratio of those receiving medication regularly was also significantly high (p=0.0022). As for the relation of SDS with various of the scores, the higher the SDS score became, the scores for ADL, information-related function, functional and emotional support network, family relationship, friendship, economic condition became significantly lower (p<0.001, respectively). In logistic regression analysis using the background factors for SDS as explanatory variables, factors such as being women (odds ratio, 1.73; 95% confidence interval, 1.10-2.72), ADL (0.80; 0.69-;0.93), emotional support network (0.88; 0.81-0.96), friendship (0.98; 0.96-0.99) were significant independent contributing factors. As for the relation between SDS and subjective senses, the more serious the SDS score became, the scores for feelings of healthiness and satisfaction became significantly smaller (both p<0.001). For prevention and amelioration of the depressive state of elderly persons living in the community, attempts should be made to improve the background factors which were clarified by the present study by efficiently utilizing health, medical and welfare services and following the future course with a positive attitude.

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