A Model for the Factors Affecting Depression in the Elderly with Chronic Disease

Cho, Eun Hi; Chun, Jin Ho; Lee, Sang Won

Abstract

BACKGROUND: In elderly, chronic diseases are common, and depression is frequently associated with the chronic physical conditions and their progress. This study was conducted to propose the basic data to assist the comprehensive care of chronically ill elderly through draw-up the trimmed model to explain the factors affecting depression.
METHODS
The subjects were 402 elderly patients (114 men, 288 women) who had been taking medication more than one year at the community health centers in the city of Busan. During March 2000, the questionnaire survey was performed on their demographic characteristics, the state of chronic disease and depression, psychosocial resources(mastery, self esteem, social support), nutritional state, economic strain, stress and functional state(ADL and IADL). The state of depression was assessed with the Short Form of Geriatric Depression Scale(SGDS) The reliability test and path analysis were done by SPSS(ver7.5) and LISREL(ver 8.3)
RESULTS
The reliability of the scales were fair in all items(Cronbach's alpha>0.5) In the state of present chronic diseases, hypertension(30.4%), musculoskeletal disorders(28.6%), and diabetes mellitus(12.8%) were common. The prevalence of depression(>6 scale in SGDS) was relatively high as 61.2%. In the result of path analysis, depression was aggravated with undermined self-esteem and mastery, chronic disease, economic strain, poor functional and nutritional state (p<0.01). Chronic disease affected depression directly(65.6%) as well as indirectly through psychosocial resources, untritional state, functional state and stress.
CONCLUSION
The results show that chronic disease were closely associated with depression, though this study was questionnaire based and limited to the elderly who visited the health centers. concludingly, when take care elderly with chronic disease, physicians'considerations about the depression as well as physically ill conditions were important for the comprehensive care.