Arayici Mehmet Emin, Kose Ali, Dolu Suleyman, Gultekin Arayici Sema, Gedik Gizem, Kilic Beyza Nur, Erkin Ozum
Department of Public Health, Faculty of Medicine, Dokuz Eylül University, Inciralti-Balcova, Izmir 35340, Turkey.
Department of Biostatistics and Medical Informatics, Faculty of Medicine, Dokuz Eylül University, Inciralti-Balcova, Izmir 35340, Turkey.
J Clin Med. 2025 Apr 21;14(8):2853. doi: 10.3390/jcm14082853.
It is a well-established fact that late-life depression represents a significant public health issue, particularly in low- and middle-income countries experiencing rapid demographic aging. Although its clinical and societal impacts are well-recognized, data on the interplay between depressive symptoms and functional status in older populations remain limited for Türkiye. This study aimed to estimate the prevalence of depression among individuals aged 65 years or older, examine its associations with instrumental and basic activities of daily living, and identify key sociodemographic and behavioral correlates. In this study, data obtained from a population-based survey in 2264 clusters by the Turkish Statistical Institute (TUIK) were used, and weighted data were yielded from 6,036,396 adults aged 65 and over. Depression was measured using the Geriatric Depression Scale (GDS), categorizing participants as "not depressed", "mildly depressed", or "severely depressed". Functional status was evaluated using the Lawton-Brody Instrumental Activities of Daily Living (IADL) Scale and the Katz Activities of Daily Living (ADL) Scale. Logistic regression models, adjusted for age and body mass index (BMI), were used to determine the associations of depression with functional impairment and various covariates, including gender, education, marital status, chronic disease, physical activity, smoking, and alcohol use. Overall, the prevalence of depression in this cohort was 49.9% [95% CI = 48.7-51%], with 36.0% [95% CI = 34.8-37.0%] classified as mild and 13.9% [95% CI = 13.1-14.7%] as severe depression. IADL and ADL scores were negatively correlated with GDS scores (r = -0.416 and r = -0.321, respectively; < 0.001). In logistic models, lower IADL scores were linked to higher odds of mild (OR = 0.797, 95% CI = [0.796-0.798], < 0.001) and severe depression (OR = 0.689, 95% CI = [0.688-0.690], < 0.001). Being semi-dependent or dependent in ADL further escalated depression risk. Female gender, lower education, single/divorced status, chronic disease, and inactivity also emerged as strong predictors. The findings of this study suggest that depression is highly prevalent among older adults in Türkiye, with functional impairment, unfavorable health behaviors, and sociodemographic vulnerabilities heightening risk. Integrating depression screening into geriatric care-alongside interventions to maintain functional independence-may help mitigate the burden of late-life depression in similar contexts.
老年期抑郁症是一个公认的重大公共卫生问题，在经历快速人口老龄化的低收入和中等收入国家尤为如此。尽管其临床和社会影响已得到充分认识，但关于土耳其老年人群中抑郁症状与功能状态之间相互作用的数据仍然有限。本研究旨在估计65岁及以上人群中抑郁症的患病率，研究其与工具性日常生活活动和基本日常生活活动的关联，并确定关键的社会人口学和行为相关因素。在本研究中，使用了土耳其统计局（TUIK）在2264个集群中进行的基于人群的调查所获得的数据，并对6036396名65岁及以上的成年人进行了加权处理。使用老年抑郁量表（GDS）测量抑郁症，将参与者分为“无抑郁”、“轻度抑郁”或“重度抑郁”。使用Lawton-Brody工具性日常生活活动（IADL）量表和Katz日常生活活动（ADL）量表评估功能状态。采用经年龄和体重指数（BMI）调整的逻辑回归模型，以确定抑郁症与功能障碍及各种协变量之间的关联，这些协变量包括性别、教育程度、婚姻状况、慢性病、体育活动、吸烟和饮酒。总体而言，该队列中抑郁症的患病率为49.9%[95%置信区间=48.7-51%]，其中36.0%[95%置信区间=34.8-37.0%]为轻度抑郁，13.9%[95%置信区间=13.1-14.7%]为重度抑郁。IADL和ADL得分与GDS得分呈负相关（分别为r=-0.416和r=-0.321；P<0.001）。在逻辑模型中，较低的IADL得分与轻度（OR=0.797，95%置信区间=[0.796-0.798]，P<0.001）和重度抑郁（OR=0.689，95%置信区间=[0.688-0.690]，P<0.001）的较高几率相关。在ADL中处于半依赖或依赖状态会进一步增加抑郁风险。女性、低教育程度、单身/离婚状态、慢性病和缺乏运动也被证明是强有力的预测因素。本研究结果表明，抑郁症在土耳其老年人中高度流行，功能障碍、不良健康行为和社会人口学脆弱性会增加风险。将抑郁症筛查纳入老年护理，并同时采取干预措施以维持功能独立性，可能有助于减轻类似情况下老年期抑郁症的负担。
