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Incidence and risk factors for late-life depression in the Ibadan Study of Ageing

Published online by Cambridge University Press:  28 January 2011

O. Gureje ,
B. Oladeji  and
T. Abiona
O. Gureje*
Affiliation:
Department of Psychiatry, University of Ibadan, University College Hospital, Ibadan, Nigeria
B. Oladeji
Affiliation:
Department of Psychiatry, University of Ibadan, University College Hospital, Ibadan, Nigeria
T. Abiona
Affiliation:
Department of Psychiatry, University of Ibadan, University College Hospital, Ibadan, Nigeria
*
*Address for correspondence: O. Gureje, M.D., D.Sc., F.R.C.Psych., Department of Psychiatry, University of Ibadan, University College Hospital, PMB 5116, Ibadan, Nigeria. (Email: [email protected])
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Abstract

Background

We present the incidence and risk factors for major depressive disorder (MDD) among community-dwelling elderly Nigerians.

Method

A cohort study of persons aged ⩾65 years residing in eight contiguous Yoruba-speaking states in south-west and north-central Nigeria was conducted between November 2003 and December 2007. Of the 2149 baseline sample, 1408 (66%) were successfully followed up after approximately 39 months. Face-to-face in-home assessments were conducted with the World Health Organization (WHO) Composite International Diagnostic Interview, version 3 (CIDI.3) and diagnosis was based on the DSM-IV. Incident MDD was determined in the group with no prior lifetime history of MDD at baseline and who were free of dementia at follow-up (n=892).

Results

During the follow-up period, 308 persons had developed incident MDD, representing a rate of 104.3 [95% confidence interval (CI) 93.3–116.6] per 1000 person-years. Compared to males, the age-adjusted hazard for females was 1.63 (95% CI 1.30–2.06). Lifetime or current subsyndromal symptoms of depression at baseline did not increase the risk of incident MDD. Among females, but not males, rural residence and poor social network were risk factors for incident MDD. Physical health status at baseline did not predict new onset of MDD.

Conclusions

The finding of a high incidence of MDD among elderly Nigerians complements earlier reports of a high prevalence of the disorder in this understudied population. Social factors, in particular those relating to social isolation, constitute a risk for incident MDD.

Keywords

Depression,elderlyincidencerisks
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 9 , September 2011 , pp. 1897 - 1906
Copyright
Copyright © Cambridge University Press 2011

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References

APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn.American Psychiatric Association: Washington, DC.Google Scholar
Areán, PA, Reynolds, CFI (2005). The impact of psychosocial factors on late-life depression. Biological Psychiatry 58, 277–282.CrossRefGoogle ScholarPubMed
Baiyewu, O, Smith Gamble, V, Lane, KA, Gureje, O, Gas, S, Ogunniyi, A, Unverzagt, FW, Hall, KS, Hendrie, HC (2007). Prevalence estimates of depression in elderly community-dwelling African Americans in Indianapolis and Yoruba in Ibadan, Nigeria. International Psychogeriatrics 19, 679–689.CrossRefGoogle ScholarPubMed
Baker, M, Stabile, M, Deri, C (2001). What do self-reported, objective, measures of health measure? Journal of Human Resources 39, 1067–1093.CrossRefGoogle Scholar
Beekman, ATF, Copeland, JR, Prince, MJ (1999). Review of community prevalence of depression in later life. British Journal of Psychatry 174, 307–311.CrossRefGoogle ScholarPubMed
Bruce, ML (2002). Psychosocial risk factors for depressive disorders in late life. Biological Psychiatry 52, 175–184.CrossRefGoogle ScholarPubMed
Bruce, ML, Hoff, RA (1994). Social and physical health risk factors for first-onset major depression disorder in a community sample. Social Psychiatry and Psychiatric Epidemiology 29, 165–171.CrossRefGoogle Scholar
Brugha, T, Bebbington, P, Tennant, C, Hurry, J (1985). The List of Threatening Experiences: a subset of 12 life event categories with considerable long-term threat. Psychological Medicine 15, 189–194.CrossRefGoogle Scholar
Brugha, T, Cragg, D (1990). The List of Threatening Experiences: the reliability and validity of a brief life events questionnaire. Acta Psychiatrica Scandinavica 82, 77–81.CrossRefGoogle ScholarPubMed
Carstensen, LL (1991). Socioemotional and selectivity theory: social activity in life-span context. Annual Review of Gerontology and Geriatrics 11, 195–217.Google Scholar
CDC (2004). Health, United States, 2004. Centers for Disease Control and Prevention: Washington, DC.Google Scholar
Ferguson, BD, Tandon, A, Gakidou, E, Murray, CJL (2003). Estimating Permanent Income Using Indicator Variables. World Health Organization: Geneva.Google Scholar
Forsell, Y, Winblad, B (1999). Incidence of major depression in a very elderly population. International Journal of Geriatric Psychiatry 14, 368–372.3.0.CO;2-Y>CrossRefGoogle Scholar
Geerlings, SW, Beekman, AT, Deeg, DJ, van Tilburg, W (2000). Physical health and the onset and persistence of depression in older adults: an eight-wave prospective community-based study. Psychological Medicine 30, 369–380.CrossRefGoogle ScholarPubMed
Gureje, O, Ademola, A, Olley, BO (2008). Depression and disability: comparisons with common physical conditions in the Ibadan Study of Aging. Journal of the American Geriatric Society 56, 2033–2038.CrossRefGoogle ScholarPubMed
Gureje, O, Kola, L, Afolabi, E (2007). Epidemiology of major depressive disorder in elderly Nigerians in the Ibadan Study of Ageing: a community-based survey. Lancet 370, 957–964.CrossRefGoogle ScholarPubMed
Gureje, O, Lasebikan, VO (2006). Use of mental health services in a developing country: results from the Nigerian survey of mental health and wellbeing. Social Psychiatry and Psychiatric Epidemiology 41, 44–49.CrossRefGoogle Scholar
Gureje, O, Ogunniyi, A, Kola, L (2006). The profile and impact of probable dementia in a sub-Saharan African community: results from the Ibadan Study of Aging. Journal of Psychosomatic Research 61, 327–333.CrossRefGoogle Scholar
Hendrie, HC, Lane, KA, Ogunniyi, A, Baiyewu, O, Gureje, O, Evans, R, Smith-Gamble, V, Pettaway, M, Unverzagt, FW, Gao, S, Hall, KS (2006). The development of a semi-structured home interview (CHIF) to directly assess function in cognitively impaired elderly people in two cultures. International Psychogeriatrics 18, 653–666.CrossRefGoogle ScholarPubMed
Hosmer, DW, Lemeshow, S (2000). Applied Logistic Regression. John Wiley & Sons: New York.CrossRefGoogle Scholar
Jorm, AF (2000). Does old age reduce the risk of anxiety and depression? A review of epidemiological studies across the adult life span. Psychological Medicine 30, 11–22.CrossRefGoogle ScholarPubMed
Katz, S, Akpom, CA (1976). A measure of primary sociobiological functions. International Journal of Health Services 6, 493–508.CrossRefGoogle ScholarPubMed
Katz, S, Ford, AB, Moskowitz, RW, Jackson, BA, Jaffe, MW (1963). Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. Journal of the American Medical Assocation 185, 914–919.CrossRefGoogle Scholar
Kessler, RC, Ustun, TB (2004). The World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93–121.CrossRefGoogle ScholarPubMed
Kessler, RC, Zhao, S, Blazer, DG, Swartz, M (1997). Prevalence, correlates, and course of minor depression and major depression in the National Comorbidity Survey. Journal of Affective Disorder 45, 19–30.CrossRefGoogle ScholarPubMed
Kish, L (1965). Survey Sampling. John Wiley & Sons: New York, NY.Google Scholar
Knight, M, Stewart-Brown, S, Fletcher, L (2001). Estimating health needs: the impact of a checklist of conditions and quality of life measurement on health information derived from community surveys. Journal of Public Health Medicine 23, 179–186.CrossRefGoogle ScholarPubMed
Kramer, M, German, PS, Anthony, JC, Von Korff, M, Skinner, EA (1985). Patterns of mental disorders among the elderly residents of eastern Baltimore. Journal of the American Geriatric Society 33, 236–245.CrossRefGoogle ScholarPubMed
Luijendijk, HJ, van den Berg, JF, Dekker, MJHJ, van Tuijl, HR, Otte, W, Smit, F, Hofman, A, Stricker, BHC, Tiemeier, H (2008). Incidence and recurrence of late-life depression. Archives of General Psychiatry 65, 1394–1401.CrossRefGoogle ScholarPubMed
Magruder, KM, Calderone, GE (2000). Public health consequences of different thresholds for the diagnosis of mental disorders. Comprehensive Psychiatry 41, 14–18.CrossRefGoogle ScholarPubMed
Meller, I, Fichter, MM, Schroppel, H (1996). Incidence of depression in octo- and nonagenerians: results of an epidemiological follow-up community study. European Archives of Psychiatry and Clinical Neuroscience 246, 93–99.CrossRefGoogle ScholarPubMed
Murray, C, Lopez, A (eds) (1996). The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries and Risk Factors in 1990 and Projected to 2020. Harvard School of Public Health: Cambridge, MA.Google Scholar
Nagi, SZ (1976). An epidemiology of disability among adults in the United States. Milbank Memorial Fund Quarterly. Health and Society 54, 439–467.Google Scholar
Norton, MC, Skoog, I, Toone, L, Corcoran, C, Tschanz, JT, Lisota, RD, Hart, AD, Zandi, PP, Breitner, JCS, Welsh-Bohmer, KA, Steffens, DC; Cache County Investigators (2006). Three year incidence of first-onset depressive syndrome in a population sample of older adults: the Cache County study. American Journal of Geriatric Psychiatry 14, 237–245.CrossRefGoogle Scholar
Palsson, SP, Ostling, S, Skoog, I (2001). The incidence of first-onset depression in a population followed from the age of 70 to 85. Psychological Medicine 31, 1159–1168.CrossRefGoogle Scholar
Pennix, BWJH, Geerlings, SW, Deeg, DJH, van Eijk, JTM, van Tilburg, W, Beekman, ATF (1999). Minor and major depression and the risk of death in older persons. Archives of General Psychiatry 56, 899–895.Google Scholar
Prince, M, Acosta, D, Chiu, H, Scazufca, M, Varghese, M (2003). Dementia diagnosis in developing countries: a cross-cultural validation study. Lancet 361, 909–917.CrossRefGoogle ScholarPubMed
Reynolds, CFI, Dew, MA, Frank, E, Begley, AE, Miller, MD, Cornes, C, Mazumdar, S, Perel, JM, Kupfer, DJ (1998). Effects of age at onset of first lifetime episode of recurrent major depression on treatment response and illness course in elderly patients. American Journal of Psychiatry 155, 795–799.Google ScholarPubMed
Rorsman, B, Gräsbeck, A, Hagnell, O, Lanke, J, Ohman, R, Ojesjö, L, Otterbeck, L (1990). A prospective study of first-incidence depression. The Lundby study, 1957–72. British Journal of Psychiatry 156, 336–342.CrossRefGoogle ScholarPubMed
Rowe, SK, Rapaport, MH (2006). Classification and treatment of sub-threshold depression. Current Opinion in Psychiatry 19, 9–13.CrossRefGoogle ScholarPubMed
StataCorp (2001). Stata Statistical Software, Version 7.0 for Windows. Stata Corporation: College Station, TX.Google Scholar
Steffens, DC, Skoog, I, Norton, MC, Hart, AD, Tschanz, JT, Plassman, BL, Wyse, BW, Welsh-Bohmer, KA, Breitner, JC (2000). Prevalence of depression and its treatment in an elderly population: the Cache County study. Archives of General Psychiatry 57, 601–607.CrossRefGoogle Scholar
Ustun, TB, Ayuso-Mateos, JL, Chatterji, S, Mathers, C, Murray, CJL (2004). Global burden of depressive disorder in the year 2000. British Journal of Psychiatry 184, 386–392.CrossRefGoogle ScholarPubMed
Weissman, MM, Leaf, PJ, Tischler, GL, Blazer, DG, Karno, M, Bruce, ML, Florio, LP (1988). Affective disorders in the United States communities. American Journal of Psychiatry 18, 141–153.Google ScholarPubMed
Welsh, KA, Butters, N, Mohs, RC, Beekly, D, Edland, S, Fillenbaum, G, Heyman, A (1994). The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part V. A normative study of the neuropsychological battery. Neurology 44, 609–614.CrossRefGoogle Scholar