Depression among Elderly Type-2 Diabetics in a Rural Community

Background: Depression and elderly type 2 diabetes mellitus often coexist but poorly studied. This study evaluates depressive symptoms and the associated risk factors among elderly type 2 diabetes mellitus patients at selected primary care clinics in rural Perak, Malaysia.Method:Face-to-face interview was conducted to collate socio-demographic data and medical history among participants. The validated Malay version of the Hospital Anxiety and Depression scale (HADS) questionnaire was used to assess anxiety and depression symptoms. The cognitive impairment was assessed using the Elderly Cognitive Assessment Questionnaire (ECAQ) to screen for cognitive impairment among elderly. Result: 510 eligible elderly diabetic patients were screened and 464 consented to participate. Majority of participants were females (58.4%), Malays (64.2%), married (82.3%), had primary education (42.5%) and non-smokers (70%). Their mean age was 59.7 ± 10.2 years. Medical history revealed that hypertension, being either obese or overweight, hypercholesterolemia and having stroke accounted for 76%, 65.9%, 42.7% and 6.3% respectively. The prevalence of depressive symptoms was 15.7% (95% CI 12.4, 19.1). Majority of participants (81.1%) had HbA1c level of 6.5% and above. Using chi-square test, significant associations were found between depression and age 60 years and above (p<0.05), unemployment (p=0.033), smokers (p=0.018), cognitive impairment (p=0.04), anxiety symptoms (p<0.001) and underweight (p< 0.038). Conclusion: Depression continues to be a public mental health issue. Its early recognition and prompt treatment are crucial particularly in minority group, unemployed individuals, smokers, cognitive impaired subjects, anxious as well as underweight individuals