Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-23T03:02:03.477Z Has data issue: false hasContentIssue false

Chronic diseases among older people and co-resident psychological morbidity: a 10/66 Dementia Research Group population-based survey

Published online by Cambridge University Press:  04 April 2011

Mina Honyashiki
Affiliation:
Kyoto University Graduate School of Medicine, School of Public Health, Department of Health Promotion and Human Behavior, Kyoto, Japan Kings College London, Institute of Psychiatry, Health Service and Population Research Department, London, United Kingdom
Cleusa P. Ferri*
Affiliation:
Kings College London, Institute of Psychiatry, Health Service and Population Research Department, London, United Kingdom
Daisy Acosta
Affiliation:
Universidad Nacional Pedro Henriquez Ureña (UNPHU), Santo Domingo, Dominican Republic
Mariella Guerra
Affiliation:
Universidad Peruana Cayetano Heredia, Lima, Peru
Yueqin Huang
Affiliation:
Peking University, Institute of Mental Health, Beijing, China
K. S. Jacob
Affiliation:
Christian Medical College, Vellore, India
Juan J. Llibre-Rodrigues
Affiliation:
Medical University of Havana, Havana, Cuba
Aquiles Salas
Affiliation:
Caracas University Hospital, Caracas, Venezuela
Ana Luisa Sosa
Affiliation:
National Institute of Neurology and Neurosurgery of Mexico, Mexico City, Mexico
Joseph Williams
Affiliation:
Community Health Department, VHS, Chennai, India
Martin J. Prince
Affiliation:
Kings College London, Institute of Psychiatry, Health Service and Population Research Department, London, United Kingdom
*
Correspondence should be addressed to: Cleusa P. Ferri, King's College London; Institute of Psychiatry, Health Service and Population Research Department, P060, De Crespigny Park, London SE5 8AF, United Kingdom. Phone: +44 (0)20 78480340; Fax: +44 (0)20 78485450. Email: [email protected].

Abstract

Background: This is the first study to investigate the associations between chronic health conditions of older people and their impact on co-resident psychological morbidity using population-based samples in low and middle income countries (LAMICs).

Methods: Single-phase cross-sectional catchment area surveys were undertaken in urban sites in Cuba, Dominican Republic and Venezuela, and in rural and urban catchment areas in Mexico, Peru, India and China. All residents aged 65 years and over were interviewed with a co-resident key informant. Exposures were structured clinical diagnoses (10/66 and DSM-IV dementia and ICD-10 depression), self-reported diagnosis (stroke) and physical impairments. Mediating variables were dependence and disability (WHODAS 2.0), and the outcome was co-resident psychological morbidity assessed using SRQ-20.

Results: Poisson regression analysis was used to estimate the prevalence ratios (PRs) for the associations between health conditions and psychological morbidity in each site, and meta-analysis was used to pool the estimates. 11,988 pairs comprising a participant and a co-resident informant were included in the analysis. After meta-analysis, independent effects were noted for depression (PR2.11; 95% CI 1.82–2.45), dementia (PR 1.98; 95% CI 1.72–2.28), stroke (PR 1.42; 95% CI 1.17–1.71) and physical impairments (PR 1.17; 95% CI 1.13–1.21). The effects were partly mediated through disability and dependence. The mean population attributable fraction of total chronic conditions was 30.1%.

Conclusion: The prevalence of co-resident psychological morbidity is higher among co-residents of older people with chronic conditions. This effect was prominent for, but not confined to, depression and dementia. Attention needs to be directed to chronic conditions.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

10/66 Dementia Research Group (2004). Care arrangements for people with dementia in developing countries. International Journal of Geriatric Psychiatry, 19, 170177.CrossRefGoogle Scholar
Acosta, D., Rottbeck, R., Rodriguez, G., Ferri, C. P. and Prince, M. J. (2008). The epidemiology of dependency among urban-dwelling older people in the Dominican Republic; a cross-sectional survey. BMC Public Health, 8, 285.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington, DC: American Psychiatric Association.Google Scholar
Beusenberg, M. and Orley, J. (1994). User's Guide to the Self Reporting Questionnaire. Geneva: World Health Organization.Google Scholar
Copeland, J. R., Prince, M., Wilson, K. C., Dewey, M. E., Payne, J. and Gurland, B. (2002). The Geriatric Mental State Examination in the 21st century. International Journal of Geriatric Psychiatry, 17, 729732.CrossRefGoogle Scholar
Cuijpers, P. (2005). Depressive disorders in caregivers of dementia patients: a systematic review. Aging and Mental Health, 9, 325330.CrossRefGoogle ScholarPubMed
Demyttenaere, K. et al. (2004). Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA, 291, 25812590.Google ScholarPubMed
Dufouil, C. and Alperovitch, A. (2000). Couple similarities for cognitive functions and psychological health. Journal of Clinical Epidemiology, 53, 589593.CrossRefGoogle ScholarPubMed
George, L. K. and Fillenbaum, G. G. (1985). OARS methodology. a decade of experience in geriatric assessment. Journal of the American Geriatrics Society, 33, 607615.CrossRefGoogle ScholarPubMed
Harpham, T. et al. (2003). Measuring mental health in a cost-effective manner. Health Policy Plan, 18, 344349.CrossRefGoogle Scholar
Higgins, J. P. and Thompson, S. G. (2002). Quantifying heterogeneity in a meta-analysis. Statistics in Medicine, 21, 15391558.CrossRefGoogle ScholarPubMed
Mathers, C. D. and Loncar, D. (2006). Projections of global mortality and burden of disease from 2002 to 2030. PLoS.Medicine, 3, e442.CrossRefGoogle ScholarPubMed
Pinquart, M. and Sorensen, S. (2003). Associations of stressors and uplifts of caregiving with caregiver burden and depressive mood: a meta-analysis. Journal of Gerontology, Series B: Psychological Sciences and Social Sciences, 58, 112128.CrossRefGoogle ScholarPubMed
Prince, M., Acosta, D., Chiu, H., Scazufca, M., Varghese, M. and Dementia Research Group (2003). Dementia diagnosis in developing countries: a cross-cultural validation study. Lancet, 361, 909917.CrossRefGoogle ScholarPubMed
Prince, M., et al. (2007). The protocols for the 10/66 Dementia Research Group population-based research programme. BMC Public Health., 7, 165.CrossRefGoogle Scholar
Prince, M. et al. (2008). Ageing and dementia in low and middle income countries: using research to engage with public and policy-makers. International Review of Psychiatry, 20, 332343.CrossRefGoogle ScholarPubMed
Rosenvinge, H., Jones, D., Judge, E. and Martin, A. (1998). Demented and chronic depressed patients attending a day hospital: stress experienced by carers. International Journal of Geriatric Psychiatry, 13, 811.3.0.CO;2-7>CrossRefGoogle Scholar
Schneider, J., Murray, J., Banerjee, S. and Mann, A. (1999). EUROCARE: a cross-national study of co-resident spouse carers for people with Alzheimer's disease: I. Factors associated with carer burden. International Journal of Geriatric Psychiatry, 14, 651661.3.0.CO;2-B>CrossRefGoogle ScholarPubMed
Schulz, R. and Beach, S. R. (1999). Caregiving as a risk factor for mortality: the Caregiver Health Effects Study. JAMA., 282, 22152219.CrossRefGoogle ScholarPubMed
Schulz, R. and Martire, L. M. (2004). Family caregiving of persons with dementia: prevalence, health effects, and support strategies. American Journal of Geriatric Psychiatry, 12, 240249.CrossRefGoogle ScholarPubMed
Siegel, M. J., Bradley, E. H., Gallo, W. T. and Kasl, S. V. (2004). The effect of spousal mental and physical health on husbands’ and wives’ depressive symptoms, among older adults: longitudinal evidence from the Health and Retirement Survey. Journal of Aging Health, 16, 398425.CrossRefGoogle ScholarPubMed
Sousa, R. M. et al. (2009). Contribution of chronic diseases to disability in elderly people in countries with low and middle incomes: a 10/66 Dementia Research Group population-based survey. Lancet, 374, 18211830.CrossRefGoogle Scholar
Sousa, R. M. et al. (2010). Measuring disability across cultures: the psychometric properties of the WHODAS II in older people from seven low- and middle-income countries. The 10/66 Dementia Research Group population-based survey. International Journal of Methods in Psychiatric Research, 19, 117.CrossRefGoogle Scholar
Stimpson, J. P. and Peek, M. K. (2005). Concordance of chronic conditions in older Mexican American couples. Preventing Chronic Disease, 2, A07.Google ScholarPubMed
Stimpson, J. P., Masel, M. C., Rudkin, L. and Peek, M. K. (2006). Shared health behaviors among older Mexican American spouses. American Journal of Health Behaviour, 30, 495502.CrossRefGoogle ScholarPubMed
Tout, K. (1989). Ageing in Developing Countries. Oxford: Oxford University Press.Google Scholar
Tower, R. B. and Kasl, S. V. (1996). Depressive symptoms across older spouses: longitudinal influences. Psychological Aging, 11, 683697.CrossRefGoogle ScholarPubMed
Uwakwe, R. et al. (2009). The epidemiology of dependence in older people in Nigeria: prevalence, determinants, informal care, and health service utilization. A 10/66 Dementia Research Group Cross-Sectional Survey. Journal of the American Geriatrics Society, 57, 16201627CrossRefGoogle ScholarPubMed
von Korff, M. et al. (2008). Modified WHODAS-II provides valid measure of global disability but filter items increased skewness. Journal of Clinical Epidemiology, 61, 11321143.CrossRefGoogle ScholarPubMed
Weich, S., Holt, G., Twigg, L., Jones, K. and Lewis, G. (2003). Geographic variation in the prevalence of common mental disorders in Britain: a multilevel investigation. American Journal of Epidemiology, 157, 730737.CrossRefGoogle Scholar
World Health Organization (2010). Measuring Health and Disability:Manual for WHO Disability Assessment Schedule (WHODAS 2.0). Geneva: WHO.Google Scholar