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Anxiety and Depression in Elderly in Three Croatian Counties Are They Associated with Socio-Demographic Characteristics?

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Anxiety and Depression in Elderly in Three Croatian Counties Are They Associated with Socio-Demographic Characteristics? ANXIETY AND DEPRESSION IN ELDERLY IN THREE CROATIAN COUNTIES ARE THEY ASSOCIATED WITH SOCIO-DEMOGRAPHIC CHARACTERISTICS? Draženka Vadla1, Jadranka Božikov2 and Luka Kovaèiæ2 1Institute of Public Health Koprivnica-Križevci County, Koprivnica, Croatia 2Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia Contact: [email protected] INTRODUCTION The number and proportion of elderly is growing and their mental health is deteriorating with ageing. KOPRIVNICA Anxiety and depression are the most common mental illness in the elderly, but they are less than 20% recognized and treated, therefore represent an important challenge in the field of research and planning of preventive programs for a long and active aging. AIMS The aim of the study was to investigate the prevalence of anxiety and depression in elderly from three Koprivnica Pula Dubrovnik Croatian counties and their association with socio-demographic characteristics: age, gender and Average age (years) 76 77 78 single/familial life. PULA Urban population (%) 50 71 65 Higher or high education (%) 2.8 7.6 7.5 Incomplete primary schooling (%) 72 48 51 Average pension (Euro) 240 337 317 METHODS A cross-sectional study was carried out in three counties, one mainly rural (Koprivnica) and two mainly urban counties (Dubrovnik and Pula), as a part of a broader study Second Decennial Survey of the Health Needs and Health care for Older People in Europe within the European network Tipping the Balance Towards Primary Health Care. A sample of 1469 people aged 70 or more were derived from the counties' population registries and interviewed in 2006. The Hospital Anxiety and Depression Scale (HAD) was used to screen for self-reported symptoms of anxiety and depression and findings were expressed as normal, borderline or probable which were further associated with DUBROVNIK socio-demographic characteristics. Data were analysed descriptively and non-parametric tests (Kruskal-Wallis, Pearson's X²) were used for comparisons. RESULTS High prevalence of probable and borderline anxiety (20% and 24%) and depression (31% and 23%, respectively) was found in elderly, with The level of anxiety was higher in women (24% probable, significant differences between counties (p<0.001). The highest prevalence of probable and borderline anxiety (28% each) and depression 25% borderline) than men (14% and 21%, respectively), (40% and 23%, respectively) was recorded in Koprivnica and the lowest in Dubrovnik (16% and 19% for anxiety and 26% and 20% for p<0.001; while for depression gender-based difference depression, respectively). The prevalence of both disorders, anxiety and depression, were slightly above in Pula than those from Dubrovnik. was not statistically significant. Prevalence of anxiety and depression in three counties Prevalence of anxiety and depression by gender 100% 70 65.6 90% 17.5 16.0 25.5 Men 28.2 27.6 60 80% 39.8 Women 51.0 19.2 48.8 24.1 50 70% 45.3 20.2 HAD Scale 60% 24.7 27.7 40 Probable 11-21 50% 23.3 % 31.9 28.2 Borderline 8-10 30 40% 25.3 Normal 0-7 23.7 23.0 22.8 64.8 20.5 30% 58.4 54.3 20 13.9 44.1 47.7 20% 36.9 10 10% 0% 0 Anxiety Depression Anxiety Depression Anxiety Depression Normal Borderline Probable Normal Borderline Probable KoprivnicaKoprivnica PulaPula DubrovnikDubrovnik AnxietyAnxiety DepressionDepression The prevalence of probable depression increases with age (from 26% in the age group 70-74 to Living alone does not significantly affect the prevalence of probable anxiety and depression, but 43% in the age group 90+; p=0.034) and that of probable anxiety decreases (from 21% to 12%, elderly who live with someone are more borderline anxious and significantly more depressed than respectively; p=0.028). those who live alone (25% and 18% respectively; p=0.026). Probable anxiety and depression by age Prevalence of anxiety and depression of elderly 45 42.6 living alone/with someone 40 60 CONCLUSIONS 56.8 55.9 35 50.9 Live alone 50 Depression 45.0 Live with someone 30 The prevalence of anxiety and depression in 26.2 Anxiety elderly is high, particularly in rural area. The 40 25 prevalence of anxiety decreases with age while % 31.1 30.5 20 that of depression increases. % 30 21.4 24.2 24.5 21.7 21.5 15 Women are more likely to show sings of anxiety 19.9 18.0 20 12.2 than man; living alone was not a significant risk 10 factor. These should be taken into account while planning provision of health care for elderly at a 10 5 local level. 0 0 70-74 75-79 80-84 85-89 90+ Normal Borderline Probable Normal Borderline Probable Age AnxietyAnxiety DepressionDepression "The Tipping the Balance Towards Primary Health Care Network" TTB Second Decennial Survey of the Health Needs and Health care for Older People in Europe 2005/2006 was (TTB) is an international network founded in 1986, at the initiative of the organized in eight regions in five European countries: Finland, Sweden, Ireland, Croatia and Greece. The main objective was: WHO European region by advocating a vision of the fundamental role of to gather information about the health of the elderly and their needs that could be used in planning the best possible care for primary health care in the organization of health care, based on the the elderly in the studied regions and to determine the relationship between health and the health needs of the elderly and the Resolution of Health for All (WHO, 1977) and the Declaration of Alma Ata (1978). provision of services to meet those needs in different regions of Europe..
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