International Psychogeriatrics

  • International Psychogeriatrics / Volume 21 / Issue 02 / April 2009, pp 372-378
  • Copyright © International Psychogeriatric Association 2009. The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution-NonCommercial-ShareAlike licence <>. The written permission of Cambridge University Press must be obtained for commercial re-use.
  • DOI: (About DOI), Published online: 26 February 2009

Research Article

Nature, prevalence and factors associated with depression among the elderly in a rural south Indian community

A. P. Rajkumara1, P. Thangaduraia1, P. Senthilkumara1, K. Gayathria1, M. Princea2 and K. S. Jacoba1 c1

a1 Department of Psychiatry, Christian Medical College, Vellore, India

a2 Institute of Psychiatry, London, U.K.


Background: Depression in old age is an important public health problem causing considerable morbidity and disability worldwide. There is a dearth of community studies from India investigating geriatric depression and its associated risk factors. This study aimed to establish the nature, prevalence and factors associated with geriatric depression in a rural south Indian community.

Methods: We recruited 1000 participants aged over 65 years from Kaniyambadi block, Vellore, India. We assessed their socio-demographic profile, psychiatric morbidity, cognitive functioning, anthropometrics and disability status using the following structured assessment tools: Geriatric Mental State, Community Screening Instrument for Dementia, Modified CERAD 10 word list learning task, History and Aetiology Schedule Dementia Diagnosis and Subtype, WHO Disability Assessment Scale II, and Neuropsychiatric Inventory. We adopted a case control framework to study the factors associated with geriatric depression.

Results: Prevalence of geriatric depression (ICD-10) within the previous one month was 12.7% (95% CI 10.64–14.76%). Low income (OR 1.78; 95% CI 1.08–2.91), experiencing hunger (OR 2.58; 95% CI 1.56–4.26), history of cardiac illnesses (OR 4.75; 95% CI 1.96–11.52), transient ischemic attack (OR 2.43; 95% CI 1.17–5.05), past head injury (OR 2.70; 95% CI 1.36–5.36) and diabetes (OR 2.33; 95% CI 1.15–4.72) increased the risk for geriatric depression after adjusting for other determinants using conditional logistic regression. Having more confidants (OR 0.13; 95% CI 0.06–0.26) was the significant protective factor. Age, female gender, cognitive impairment and disability status were not significantly associated with geriatric depression. DSM-IV diagnosis of major depression was significantly correlated with experiencing hunger, diabetes, transient ischemic attack, past head injury, more disability and less nourishment; having more friends was protective.

Conclusions: Geriatric depression is prevalent in rural south India. Poverty and physical ill health are risk factors for depression among elderly while good social support is protective.

(Received November 03 2008)

(Revised December 03 2008)

(Revised December 11 2008)

(Accepted December 15 2008)


c1 Correspondence should be addressed to: K. S. Jacob, Professor of Psychiatry, Christian Medical College, Vellore 632002, India. Phone: +91 416 228 4513; Fax: +91 416 226 2268. Email: