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Co-occurrence of anxiety and depression amongst older adults in low- and middle-income countries: findings from the 10/66 study

Published online by Cambridge University Press:  05 April 2011

A. M. Prina ,
C. P. Ferri ,
M. Guerra ,
C. Brayne  and
M. Prince
A. M. Prina*
Affiliation:
Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK
C. P. Ferri
Affiliation:
King's College London, Institute of Psychiatry, Health Service and Population Research Department, Centre for Public Mental Health, London, UK
M. Guerra
Affiliation:
King's College London, Institute of Psychiatry, Health Service and Population Research Department, Centre for Public Mental Health, London, UK Universidad Peruana Cayetano Heredia, Lima, Peru Institute de la Memoria y Desordenes Relacionadas, Lima, Peru
C. Brayne
Affiliation:
Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK
M. Prince
Affiliation:
King's College London, Institute of Psychiatry, Health Service and Population Research Department, Centre for Public Mental Health, London, UK
*
*Address for correspondence: A. M. Prina, M.Phil., Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK. (Email: amp68@medschl.cam.ac.uk)
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Abstract

Background

There is relative little information about the prevalence and risk factors of co-morbid anxiety and depression in later life. These disorders are often associated with worse response to treatment than either condition alone, and researching their epidemiology in diverse settings is vital to policy makers. We therefore investigated the co-occurrence of anxiety and depressive syndromes amongst older adults living in developing countries and measured the separate and joint effect of these two disorders on levels of associated disability.

Method

The 10/66 study carried out cross-cultural surveys of all residents aged 65 years or over (n=15021) in 11 sites in seven countries (People's Republic of China, India, Cuba, Dominican Republic, Venezuela, Mexico and Peru). Anxiety was measured by using the Geriatric Mental State Examination and the Automated Geriatric Examination for Computer Assisted Taxonomy diagnostic system. Depression was assessed according to International Classification of Diseases 10th revision (ICD-10) and EURO-D criteria. Disability was measured by using the World Health Organization's Disablement Assessment Scale Version II. Zero-inflated negative binomial regression models were used to investigate the association of common mental disorders and disability.

Results

The prevalence of co-occurring anxiety and depression (with the exclusion of subthreshold disorders) ranged between 0.9% and 4.2% across sites. Gender, socio-economic status, urbanicity and physical co-morbidities were associated with the different co-morbid states. Having both disorders was linked to higher disability scores than having anxiety or depression alone.

Conclusions

Given the close association of co-morbid anxiety and depression with disability, new policies to improve prevention, recognition and treatment will be needed to adapt to ageing populations and their mental health needs.

Keywords

Anxietyco-morbiditydepressionepidemiologyold age
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 10 , October 2011 , pp. 2047 - 2056
Copyright
Copyright © Cambridge University Press 2011

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