Factors Influencing the Prevalence of Mental Health Problems among Malay Elderly Residing in a Rural Community: A Cross-Sectional Study

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Abstract

Background and Purpose

Mental health problems are common in old age, but frequently remain undetected and untreated. Mental health problems in the elderly are the result of a complex interaction of social, psychological and biological factors. The aim of this study is to determine the prevalence of mental health problems (depression, anxiety, and emotional stress) and their associated factors among the Malay elderly in a rural community of Perak, Malaysia.

Methods

It was a cross-sectional study. The Malay elderly aged 60 years and above were selected through convenient sampling to give a total of 230 respondents. The Depression, Anxiety, and Stress Scale (DASS-21) was used to assess the symptoms of depression, anxiety, and stress. Bivariate analyses were performed using chi-square tests and multiple logistic regression analyses were conducted to determine the association between the factors and each of the mental health statuses assessed.

Results

The results showed that the prevalence of depression, anxiety, and stress among the elderly respondents was 27.8%, 22.6%, and 8.7%, respectively. The significant factors for depression were single elderly (Adjusted OR = 3.27, 95%CI 1.66, 6.44), living with family (Adjusted OR = 4.98, 95%CI 2.05, 12.10), and poor general health status (Adjusted OR = 2.28, 95%CI 1.20, 4.36). Living with family was the only significant factor for anxiety (Adjusted OR = 2.68, 95%CI 1.09, 6.57). There was no significant factor for stress.

Conclusions

Depression and anxiety among the Malay elderly in the rural community were very worrying. More equity in health should be created or strengthened in order to intensify the opportunity to identify, diagnose, and treat those with mental health problems. Living arrangement in the rural community was an important factor that had influenced depression and anxiety. Therefore, further research is recommended for more comprehensive information, as a result of which appropriate intervention can be made.

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Most cited references 10

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Living arrangements, social integration, and change in functional health status.

L Berkman, I Kawachi, G. A. Colditz … (2001)

Limited prospective data have examined the association between living arrangements and emotional wellbeing. The authors assessed whether older women living with a spouse were less likely to experience a decline in mental health, vitality, or physical function compared with women living alone or with nonspouse others. The association between living arrangement and 4-year change in functional health status was examined prospectively among 28,324 women aged 60-72 years in the Nurses' Health Study. After adjustment for age, baseline function, comorbid conditions, and health behaviors, women living alone had lower risk of decline in mental health (relative risk (RR) = 0.73, 95 percent confidence interval (CI): 0.65, 0.81) and vitality (RR = 0.72, 95 percent CI: 0.65, 0.80) compared with those living with a spouse. Contact with friends and relatives and level of social engagement were significantly protective against a decline in mental health among women living alone but not among women living with a spouse. These results suggest that women living independently are neither socially isolated nor at increased risk for decline in functional health status. In fact, these women actually fare better on measures of psychologic function than do women living with a spouse.

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Health status and risk for depression among the elderly: a meta-analysis of published literature.

LIU QING, Yue Rong, Zhang Xue … (2009)

the goal of this study was to determine the relationship between health status, including self-rated health status and chronic disease, and risk for depression among the elderly. MEDLINE, EMBASE and The Cochrane Library Database were used to identify potential studies. The studies were classified into cross-sectional and longitudinal subsets. For each study, the numbers of the total participants, cases (for cross-sectional study) or incident cases (for longitudinal study) of depression in each health status group were extracted and entered into Review Manager 4.2. The quantitative meta-analysis of cross-sectional studies and that of longitudinal studies were performed, respectively. For prevalence and incidence rates of depression, odds risk and relative risk (RR) were calculated, respectively. the quantitative meta-analysis showed that, compared with the elderly without chronic disease, those with chronic disease had higher risk for depression (RR: 1.53, 95% confidence intervals (CI): 1.20-1.97). Compared with the elderly with good self-rated health, those with poor self-rated health had higher risk for depression (RR: 2.40, 95% CI: 1.94-2.97). despite the methodological limitations of this meta-analysis, both poor self-rated health status and the presence of chronic disease are risk factors for depression among the elderly. In the elderly, poor self-reported health status appears to be more strongly associated with depression than the presence of chronic disease.

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Depression in the elderly: Does family system play a role? A cross-sectional study

Ather Taqui, Ahmed Itrat, Waris Qidwai … (2007)

Background The most common geriatric psychiatric disorder is depression. The role of family systems in depression among the elderly has not been studied extensively. It has been suggested that urbanization promotes nucleation of family systems and a decrease in care and support for the elderly. We conducted this study in Karachi, a large urban city of Pakistan, to determine the relationship between the type of family system and depression. We also determined the prevalence of depression in the elderly, as well as correlation of depression with other important socio-demographic variables. Methods A cross-sectional study was carried out in the premises of a tertiary care hospital in Karachi, Pakistan. Questionnaire based interviews were conducted among the elderly people visiting the hospital. Depression was assessed using the 15-item Geriatric Depression Scale. Results Four hundred subjects aged 65 and above were interviewed. The age of majority of the subjects ranged from 65 to 74 years. Seventy eight percent of the subjects were male. The prevalence of depression was found to be 19.8%. Multiple logistic regression analysis revealed that the following were significant (p < 0.05) independent predictors of depression: nuclear family system, female sex, being single or divorced/widowed, unemployment and having a low level of education. The elderly living in a nuclear family system were 4.3 times more likely to suffer from depression than those living in a joint family system (AOR = 4.3 [95% CI = 2.4–7.6]). Conclusion The present study found that residing in a nuclear family system is a strong independent predictor of depression in the elderly. The prevalence of depression in the elderly population in our study was moderately high and a cause of concern. The transition in family systems towards nucleation may have a major deleterious effect on the physical and mental health of the elderly.

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Author and article information

Contributors

Robert K Hills: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 9 June 2016

Publication date Collection: 2016

Volume: 11

Issue: 6

Electronic Location Identifier: e0156937

Affiliations

[1 ]Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia

[2 ]Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia

Cardiff University, UNITED KINGDOM

Author notes

Competing Interests: The authors have declared that no competing interests exist.

Conceived and designed the experiments: MRAM MRAR KHY NAAA. Performed the experiments: MRAM MRAR KHY. Analyzed the data: MRAM MM KHY. Contributed reagents/materials/analysis tools: MRAM MRAR KHY. Wrote the paper: MRAM MM NAAA.

* E-mail: mrizal@ 123456ppukm.ukm.edu.my

Author information

M. Rizal Abdul Manaf http://orcid.org/0000-0002-0813-8376

Article

Publisher ID: PONE-D-15-30811

DOI: 10.1371/journal.pone.0156937

PMC ID: 4900557

PubMed ID: 27280529

SO-VID: c3b03af2-2869-4029-9f8c-8c75585784cc

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 14 July 2015

Date accepted : 23 May 2016

Page count

Figures: 0, Tables: 6, Pages: 12

Funding

Funded by: funder-id http://dx.doi.org/10.13039/501100004515, Universiti Kebangsaan Malaysia;

Award ID: UKM 1.5.3.5/244/FF-2013-283

Award Recipient :

ORCID: http://orcid.org/0000-0002-0813-8376

M Rizal Abdul Manaf

This work was supported by Universiti Kebangsaan Malaysia (FF-2013-283) ( www.ukm.my/sppi/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Data Availability In order to protect participants' privacy, data are not available/deposited in an appropriate public repository, or available from a different source. Thus there are some restrictions on the ability of authors to publicly share data. Anyway, all data needed to replicate the findings are within the paper. For further queries, kindly contact ( mrizal@ 123456ppukm.ukm.edu.my ).

Factors Influencing the Prevalence of Mental Health Problems among Malay Elderly Residing in a Rural Community: A Cross-Sectional Study

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Most cited references 10

Living arrangements, social integration, and change in functional health status.

Health status and risk for depression among the elderly: a meta-analysis of published literature.

Depression in the elderly: Does family system play a role? A cross-sectional study

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