Study on Factors Associated with Depression among Elderly and Comparison of Two Scales Used for Screening

BACKGROUND: Depression is one of the most frequent illnesses found among the elderly. ICD-10 scale and Geriatric Depression Scale (GDS) are used commonly for screening and hence it is important to identify the scale which can be used more effectively in community settings. OBJECTIVES: (1) To analyze the factors responsible for the elderly depression and (2) to compare two scales used for the screening (ICD-10 and GDS). MATERIALS AND METHODS: A cross-sectional house-to-house survey was carried in Sayla taluka of Surendranagar district by directly questioning the subjects after oral and written consent. The selection of taluka was done using simple random sampling and sample size was calculated on the basis of estimated geriatric population. 306 subjects were interviewed using a predesigned, pretested, and validated questionnaire. RESULTS: GDS showed the prevalence of 16% whereas ICD-10 showed 22%. The factors associated with depression were physical health, poor economical situation, and avoidance by family members. The agreement between the 2 scales using Cohen's kappa statistic showed excellent agreement. CONCLUSION: Community-based multiphasic screening programs is needed for early diagnosis of geriatric depression. ICD-10 having lesser number of questions can be used in the 1(st) phase of screening and those found positive can then be tested by GDS.