The association between depression and quality of life in the elderly

Abstract Background Depression is the most common cause of emotional disorder in older adults causing functional impairment and leading to lower quality of life (QOL). The aim of the study was to investigate the prevalence of depression, measure the perceived QOL and evaluate the impact of depression on life quality of older people in the community. Methods We conducted a cross-sectional study in older people, enrolled in open day care centers and other healthcare facilities. To all participants the Greek validated version of the Geriatric Depression Scale (GDS-15) was applied to screen for depressive symptoms and the EQ-5D-5L scale to estimate their self-reported health status. Results A total of 634 seniors participated in the study, 53% were females, mean age 78 years. 45.6% of the participants showed moderate to severe depression. Those who suffered from at least two chronic diseases (75.6%) were more likely to develop moderate or severe depressive symptoms compared to those with only one (19.3%) or none (2.2%) chronic disease. Increased risk of depression was observed in people with Parkinson’s disease (56.5%), mental illness (47.1%), respiratory disease (40%) and stroke (35.1%). Regarding the EQ-5D-5L scale, 72% reported slight to extreme anxiety or depression, 68.2% slight to extreme pain or discomfort, 59.8% slight to extreme problems in performing usual activities, 59.8% in mobility and 40.1% in self-care, respectively. Significant differences were found between people with or without depression. Specifically, participants who reported slight to severe problems in all five domains of the EQ-5D-5L, showed higher levels of depression in the GDS-15. Conclusions Our results revealed that elderly with depressive symptoms have a lower quality of life. Given the mutual relationship between chronic diseases, lower life quality and depression, assessment of depressive symptoms are needed in elderly population, mainly in people with multiple chronic diseases. Key messages • Depression can be a predictor of poorer quality of life in older population.


Background:
Tuberculosis (TB) remains a global public health threat.WHO determined Kazakhstan as one of 18 high-priority countries for TB elimination in Europe, with reported TB incidence >20 cases per 100,000 population.There is a lack of comprehensive reseach of TB epidemiology in the country.This study aims to estimate the prevalence, incidence, mortality rates and survival hazard ratios of TB in Kazakhstan, using large-scale administrative health data records in 2014-2019.

Methods:
This is a population-wide retrospective study assessing 150 thousand TB (ICD10: A15-A19) patients' incidence, prevalence and mortality.Demographic factors, diagnoses and comorbidities were analyzed.Univariate, bivariate and multivariate statistical analyses were performed.Cox regression and Kaplan-Meier survival analysis have been done.

Results:
Out of 150 thousand all TB patients, 61 percent were male and 94 percent had respiratory TB.During 2014-2019, the TB incidence, prevalence and mortality per 100K population declined (227-15.2), doubled (325.3-746.6)and increased (8.4-15.2),respectively.Age-specific TB incidence was lowest for 0-10 y.o., highest for 20 y.o.Being an old person, male, urban resident, retired, with HIV and diabetes was significantly associated with lower survival compared to a young, female, rural resident, employed, with no comorbidities.

Conclusions:
This was the largest TB study in Kazakhstan, presenting the country's TB by demographic groups, incidence, prevalence, mortality trends, and risk factors against survival.

Background:
A current aging of the European population call questions into how to protect a high quality of health in the elderly which was the reason to establish the longitudinal HAIE Project.As the baseline information, the longitudinal ELSPAC study results were used.The aim of the analysis was to learn a life-coursedependent risk factors of the onset chronic diseases in middleaged population.

Methods:
The cohort includes data on both parents.Their number decreased during the follow up from 4,500 to about 1,000 parents.The selected questionnaire data of the cohort gained at consecutive intervals during the years 1990-2010 were analysed descriptively, according the distribution of data by respective statistical methods and survival analysis.Differences between curves were tested by log-rank tests (significance level of 5%).The SW Stata v.15 was used.

Results:
The mean age of mothers (N = 823) at study entry was 25.0 years (SD = 4.86), the age of fathers (N = 385) 28.8 years (SD = 6.05).Good self-reported health has decreased continually over time from more than 80% in both parents aged 30 to about 50% in the age of mid-forties.Most parents suffered from back pain, hypertension, and joint pain.The prevalence of diseases has raised over time.Problems with hypertension begin in women from the age of 38 (39 in men) and there was no statistically significant difference by sex (p = 0.265).Survival analysis found a significant difference by sex for depression (p < 0.001) and physician-confirmed back pain (p < 0.001), which affect parents from 35 years (significantly more in women than men).
About 50% of the mid-forties aged population did not declare good self-reported health.They suffered mostly from back pain, hypertension, and joint pain.The diseases prevalence has raised over time.The onset of hypertension begin from the age of 38 (39) with no difference by sex, depression and physician-confirmed back pain start from 35 years of age, significantly more in women than men.