Depressive symptomatology and associated factors in elderly people in a rural Context

Abstract

Depression is considered the most prevalent mood disorder in older people, generating a significant burden in the economic, personal and social spheres. It is established as a geriatric syndrome. The objective of the research was to determine the level of depressive symptoms and the associated factors in a group of older people from a rural context. This is a descriptive and cross-sectional study, with a population of older people, the type of sampling was non-probabilistic for convenience. Demographic factors evaluated according to self-report by the participant, family member or responsible caregiver were considered. Using a pre-designed and validated questionnaire, we inquired about age in years, gender, education, marital status, socioeconomic stratum level, employment status and economic dependency. Likewise, a history of chronic infectious diseases was found out. As instruments, the Yesavage scale was used, a self-report instrument, composed of 15 items that measure the presence of depressive symptoms through direct questions, the Minimental Test, a widely used instrument for the detection of global cognitive impairment, due to its speed and ease of scoring. The Life Questionnaire is a tool that evaluates performance in instrumental activities of daily living, To evaluate the use of living space, the Life Space Assessment (LSA) scale was chosen, a self-report measure requiring respondents to quantify how far and how often they have moved with or without assistance during the last four weeks. Latent class analysis was used to identify subgroups, according to patterns of depressive symptomatology. Results: 288 participants were included, aged between 60 and 93 years, with a higher proportion of women (57 %) from socioeconomic stratum 1 (99.7 %), with a low level of education (41 % with incomplete primary school). The average of the Yesavage scale was 10 (IR: 9 to 11). The analysis model presents four classes or subgroups of depressive symptom profiles with an entropy equal to 0.98. Classes 1, 2 and 3 show a predominance of depressive symptoms in the sample, with 3.81 %, 23.2 % and 21.6 %, respectively. The fourth class corresponds to moderate symptoms and would be present in 51.35 % of the sample. Regarding demographic characteristics, heterogeneity is observed at the level of the four subgroups. At the level of global cognitive performance, the results showed that it is one of the variables with the highest incidence in depressive symptoms in all groups. In relation to the total score in the VIDA questionnaire, compared to class 4, class 1 presented a SMD = -0.1 [95 % CI (-.716 - .51)], class 2 a SMD = .53 [95 % CI (-. .23 - .83)] and class 3 a SMD = -0.05 [95 % CI (-.33 - .24)]. On the LSA scale, compared to class 4, class 1 presented a SMD = -.62 [95 % CI (-1.233 - 0)], class 2 had a SMD = .42 [95 % CI (.12 - .72)] and class 3 a SMD = -.49 [95 % CI (-.78 - -.19)]. Regarding the Minimental Test, compared to class 4, class 1 presented a SMD = .62 [95 % CI (0 - 1.23)], class 2 a SMD = .46 [95 % CI (.16 - .76)] and class 3 a SMD = -.04 [95 % CI (-.33 - .25)]. It is concluded that the study shows significant associations between the presence of depressive symptoms in relation to demographic characteristics and cognitive performance, preferably, However, factors such as the use of living space and autonomy may present a bidirectional relationship with the analysis variable. © (2024), (Centro Interamericano de Investigaciones Psicologicas y Ciencias Afines). All Rights Reserved.