Patel Mamta, Bhardwaj Pankaj, Nebhinani Naresh, Goel Akhil Dhanesh, Patel Kamlesh
School of Public Health, AIIMS, Jodhpur, Rajasthan, India.
Department of Community Medicine and Family Medicine, AIIMS, Jodhpur, Rajasthan, India.
J Family Med Prim Care. 2020 Feb 28;9(2):714-720. doi: 10.4103/jfmpc.jfmpc_1016_19. eCollection 2020 Feb.
Ageing is an inescapable reality of human existence. The elderly population of India is steadily increasing with growing mental health needs which pose many challenges for the health care system. The aim of this study is to assess anxiety, depression, and cognitive disorders among urban and rural elderly and to explore the availability of social support mechanisms and a responsive health system for elderly.
This study is a mixed-method approach. For a quantitative study, a community-based cross-sectional survey is conducted in Jodhpur, Rajasthan. A total of 330 elderly persons aged 60 years and above are randomly screened for depression (GDS), anxiety (GAD), and cognitive impairment (HMSE). Further for a qualitative study, in-depth interviews are conducted with 7 key informants including policy and program managers, service providers, and facilitators from the state. For quantitative data analysis, Excel and SPSS are used and for Qualitative data analysis, Thematic Framework Approach is used.
The mean age of the respondents is 67.9 ± 7.8. The prevalence of severe depression is 17%, severe anxiety is 10.3%, and cognitive impairment is 51.2%. The prevalence of all the three is more in rural elderly as compared to urban elderly as well as more in female individuals as compared to males. Qualitative analysis revealed that there are challenges in early identification of mental disorders at both the levels: service providers and elderly. Psychological and financial issues are also seen in elderly who are not supported by their children. There are cases of fear for elder abuse and influence of western culture in the society.
There is a sizeable prevalence of psychological issues in elderly population. Therefore, there is a need to adopt holistic and integrated psychogeriatric services for the improvement of quality of life in elderly.
衰老是人类生存不可避免的现实。印度老年人口在稳步增加，心理健康需求也日益增长，这给医疗保健系统带来了诸多挑战。本研究的目的是评估城乡老年人中的焦虑、抑郁和认知障碍情况，并探索社会支持机制的可及性以及针对老年人的响应式医疗系统。
本研究采用混合方法。对于定量研究，在拉贾斯坦邦焦特布尔进行了一项基于社区的横断面调查。总共随机筛选了330名60岁及以上的老年人，以评估抑郁（老年抑郁量表）、焦虑（广泛性焦虑量表）和认知障碍（简易精神状态检查表）情况。进一步地，对于定性研究，对7名关键信息提供者进行了深入访谈，包括政策和项目管理人员、服务提供者以及该邦的协调人员。定量数据分析使用Excel和SPSS，定性数据分析使用主题框架法。
受访者的平均年龄为67.9 ± 7.8岁。重度抑郁的患病率为17%，重度焦虑为10.3%，认知障碍为51.2%。与城市老年人相比，这三种情况在农村老年人中的患病率更高；与男性相比，在女性个体中患病率更高。定性分析显示，在服务提供者和老年人这两个层面，精神障碍的早期识别都存在挑战。在没有子女支持的老年人中还存在心理和经济问题。存在对老年人受虐待的恐惧以及西方文化在社会中的影响等情况。
老年人群中心理问题的患病率相当高。因此，需要采用全面综合的老年精神科服务来改善老年人的生活质量。
