Depression and Cognitive Impairment among the Community Dwelling Elderly in a Community of Khon Kaen : A Primary Care Setting Descriptive Study.

Abstract

Abstract
Background: In elderly people, there has been a rapid increasing prevalence of both depression and cognitive impairment. However, the magnitude of geriatric depression and cognitive impairment in primary care of northeastern Thailand is not well understood.
Objective: To explore the prevalence of depression and cognitive impairments, as well as their association among the elderly community residents (age > 60) in an urban primary care unit of Khon Kaen.
Methods: This study was a descriptive study. There were 13,604 individuals lived in there and registered at PCU Samliam, and 1,662 elderly residents were listed for systematic random sampling. Sample size was 206 subjects as needed. Instruments were used as the following: 1) Thai Geriatric Depression Scale (TGDS) for screening depression with TGDS>13, 2) Thai Mental State Examination (TMSE) for screening cognitive impairment with TMSE < 24, 3) medical records from primary care for diagnoses of depression
and five selective chronic medical conditions (i.e. hypertension, diabetes mellitus, chronic obstructive pulmonary disease, coronary heart disease and chronic pain symptoms >6 months) 4) questionnaire for demographic data and stressful life events. Data analysis was conducted by percent, prevalence rate with 95%CI, odds ratio, and multiple logistic regression.
Results: The sample consisted of 200 subjects who registered in Primary Care Unit Sam Liam. The response rate was 97.1%. There were 87 (43.5%) males and 113 (56.5%) females. Their mean age was 69.2+7.2 years (range: 60 - 96 years). The prevalence of depression and cognitive impairment were 21.0% (95%CI:15.3%, 26.7%) and 27.0% (95%CI: 20.8%, 33.2%) respectively. Age, ischemic heart disease, cognitive impairment, life crisis were risk factors which associated with depression.
Conclusion: There was a high prevalence of depression and cognitive impairment in primary health care setting. Depression rose with age, and significantly related to cognitive impairment, ischemic heart
disease and life crisis.