Depression Among Elderly Users of Open and Closed Care Facilities in a Rural Region of Greece: an Important Public Health Issue

INTRODUCTION: It is estimated that 5.7% of the total Greek population suffers from depressive disorders. Elderly may be particularly prone to depression compared to younger people. In Greece, there is a paucity of literature regarding the correlation between the existence of chronic diseases, sociodemographic features, participation in open/ closed structures, and the presence of depression or depressive symptoms, among seniors. The purpose of this study was to explore potential correlations between the above- mentioned variables, as a whole. METHODS: This was a cross- sectional, questionnaire survey of 200 elderly aged 65 or above and were members of 12 Open Care Centers for the Elderly (OCCE) or residents in 2 nursing homes located in the rural region of Epirus, in Greece. Data collection took place in the form of structured individual interviews. For the identification of independent factors associated with the existence of depressive symptoms, stepwise logistic regression analysis was performed. RESULTS: A total of 81 (40.5%) seniors experienced depressive symptoms, though only 39 of them (19.5%) had been diagnosed for depression. Depression rates were higher for those with more chronic diseases (p=0.01) and at divorced, widowed and single seniors compared to married ones (50.5% vs. 28.1% respectively, p=0.002). The prevalence of depression was higher among the elderly who lived in nursing homes compared to the participants who were registered members of the OCCE (50% vs. 35.6% respectively, p=0.049), while elderly who often participated in the social activities of OCCE, had significantly lower rates of depressive symptoms compared to those who scarcely were involved in these activities (23% vs. 46.2% respectively, p=0.019). Participants who suffered from osteoporosis were more likely of displaying depressive symptoms compared to those who didn’t; OR (95% Confidence Interval) = 2.61 (1.28-5.33), p=0.009. CONCLUSIONS: The existence of an action plan that includes education and training of health professionals on mental health of the elderly and the satisfactory operation of public facilities to promote the wellbeing of seniors and offer more incentives for activity participation, may reduce depression rates and the under-diagnosis of the disease.