Indian Journal of Public Health

LETTER TO THE EDITOR
Year
: 2015  |  Volume : 59  |  Issue : 4  |  Page : 330--331

Comment on: Prevalence of depression and associated risk factors among the elderly in urban and rural field practice areas of a tertiary care institution in Ludhiana


Priyamadhaba Behera1, Sanjeev Kumar Gupta2,  
1 Junior Resident, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
2 Professor, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Sanjeev Kumar Gupta
Professor, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi - 110 029
India




How to cite this article:
Behera P, Gupta SK. Comment on: Prevalence of depression and associated risk factors among the elderly in urban and rural field practice areas of a tertiary care institution in Ludhiana.Indian J Public Health 2015;59:330-331


How to cite this URL:
Behera P, Gupta SK. Comment on: Prevalence of depression and associated risk factors among the elderly in urban and rural field practice areas of a tertiary care institution in Ludhiana. Indian J Public Health [serial online] 2015 [cited 2019 Jun 24 ];59:330-331
Available from: http://www.ijph.in/text.asp?2015/59/4/330/169676


Full Text

Sir,

This bears reference to the article entitled "Prevalence of depression and associated risk factors among the elderly in urban and rural field practice areas of a tertiary care institution in Ludhiana" by Sengupta and Benjamin, published in the India Journal of Public Health 2015; 59. [1] The authors need to be applauded for the conduct of a large community-based study on this important topic. In this study, Geriatric Depression Scale-15 has been used to identify depression. The authors have rightly mentioned that it is a screening instrument. However, this instrument is not valid in patients with cognitive impairment. [2] It fails to identify depression in cognitively impaired elderly persons. Hence, it would have been better to exclude the patients who were found to have cognitive impairment after conducting the mini-mental state examination. This may result in some underestimates of the prevalence of depression. This is acceptable. The authors have excluded participants who were blind and who reported parkinsonism. The reason for excluding them is not clear. Depression is associated with parkinsonism. [3] Studies have demonstrated that depression is more common among blind people. [4] Participants with these conditions could have responded to the questionnaires. Physical activity has a strong association with depression. [5] The prevalence of depression has been found to be lower among those elderly persons engaged in some physical activity. Among those who were "not working" in this study, it would have been better to desegregate homemakers.

It was reported that there were 3,054 elderly people in the population under study. Of these 3,038 participated in the investigation. Thus, 16 elderly were excluded. The exclusion criteria were deaf/dumb/blind, those diagnosed with psychiatric illness (schizophrenia, mental retardation) or neurological disorders (parkinsonism, severe head injury, or brain neoplasm) and those who were ill at the time of the study. It would be interesting to look at the distribution of these conditions among the 16 elderly people who were excluded. As the prevalence of blindness [vision <3/60 in the better eye - World Health Organization (WHO) criteria] among the elderly is about 3.2% in urban areas and 5% in rural areas, there should have been at least 100 blind elderly persons in the study population. [6] As an ethical requirement, management of depression among the identified elderly persons should have been mentioned.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Sengupta P, Benjamin AI. Prevalence of depression and associated risk factors among the elderly in urban and rural field practice areas of a tertiary care institution in Ludhiana. Indian J Public Health 2015;59:3-8.
2Montorio I, Izal M. The geriatric depression scale: A review of its development and utility. Int Psychogeriatr 1996;8: 103-12.
3Menon B, Nayar R, Kumar S, Cherkil S, Venkatachalam A, Surendran K, et al. Parkinson's disease, depression, and quality-of-life. Indian J Psychol Med 2015;37:144-8.
4Evans JR, Fletcher AE, Wormald RP. Depression and anxiety in visually impaired older people. Ophthalmology 2007;114:283-8.
5Loprinzi PD. Objectively measured light and moderate-to-vigorous physical activity is associated with lower depression levels among older US adults. Aging Ment Health 2013;17:801-5.
6Patil S, Gogate P, Vora S, Ainapure S, Hingane RN, Kulkarni AN, et al. Prevalence, causes of blindness, visual impairment and cataract surgical services in Sindhudurg district on the western coastal strip of India. Indian J Ophthalmol 2014;62:240-5.