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Prevalence of depression and anxiety in older people in low- and middle- income countries in Africa, Asia and South America : A systematic review and meta-analysis

Edwards, N ; Walker, S ; Paddick, S-M ; Prina, A M ; Chinnasamy, M ; Reddy, N ; Mboya, I B LU orcid ; Mtei, M ; Varghese, M and Nakkasuja, N , et al. (2023) In Journal of Affective Disorders 325. p.656-674
Abstract

BACKGROUND: There is rapid growth of older people in Low- and Middle- Income Countries (LMICs). The aim of this review was to assess the literature on prevalence of anxiety and depression in this demographic, which to our knowledge, has not yet been conducted.

METHODS: Databases including Medline, PsychInfo, Embase, Scielo and African Journals Online were searched for terms including "mental disorders", "neurotic disorders", "mood disorders" and "anxiety disorders". Studies published between 1990 and 2020 providing data on older people (≥50 years) in LMICs (defined by World Bank Criteria) were included and quality-assessed. Meta-analysis was conducted on a subset of higher-quality studies to derive pooled prevalence estimates of... (More)

BACKGROUND: There is rapid growth of older people in Low- and Middle- Income Countries (LMICs). The aim of this review was to assess the literature on prevalence of anxiety and depression in this demographic, which to our knowledge, has not yet been conducted.

METHODS: Databases including Medline, PsychInfo, Embase, Scielo and African Journals Online were searched for terms including "mental disorders", "neurotic disorders", "mood disorders" and "anxiety disorders". Studies published between 1990 and 2020 providing data on older people (≥50 years) in LMICs (defined by World Bank Criteria) were included and quality-assessed. Meta-analysis was conducted on a subset of higher-quality studies to derive pooled prevalence estimates of depression.

RESULTS: One hundred and forty relevant studies were identified, of which thirty-two were included in meta-analysis. One hundred and fifteen studies reported depression prevalence only, 19 reported both depression and anxiety, and six reported anxiety only. In all studies identified, depression prevalence ranged from 0.5 % to 62.7 %, and Generalised Anxiety Disorder prevalence ranged from 0.2 % to 32.2 %. The pooled prevalence of depression on meta-analysis was 10.5 % (95 % CI, 8.9 % - 11.2 %). Reported prevalence rates of depression were significantly different in studies using ICD-10 compared with DSM criteria, and between community and clinical settings.

LIMITATIONS: The search strategy contained bias towards English language papers and high income country (HIC) publications. There is significant heterogeneity within the meta-analysis.

DISCUSSION: A wide range of methodologies and clinical criteria are used in prevalence studies of depression and anxiety in older people. Studies using screening tools found higher prevalence rates; clinicians and researchers should ensure diagnosis is made with gold-standard clinical criteria. Meta-analysis data suggest that rates of depression are similar in older people in LMICs compared to HICs but mental healthcare resources are limited, suggesting a large potential treatment gap.

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publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Affective Disorders
volume
325
pages
19 pages
publisher
Elsevier
external identifiers
  • pmid:36681304
  • scopus:85146596795
ISSN
0165-0327
DOI
10.1016/j.jad.2023.01.068
language
English
LU publication?
no
additional info
Crown Copyright © 2023. Published by Elsevier B.V. All rights reserved.
id
fd64caf9-f4e4-4041-a95b-50f176d9536d
date added to LUP
2023-01-26 12:01:10
date last changed
2024-05-04 18:42:56
@article{fd64caf9-f4e4-4041-a95b-50f176d9536d,
  abstract     = {{<p>BACKGROUND: There is rapid growth of older people in Low- and Middle- Income Countries (LMICs). The aim of this review was to assess the literature on prevalence of anxiety and depression in this demographic, which to our knowledge, has not yet been conducted.</p><p>METHODS: Databases including Medline, PsychInfo, Embase, Scielo and African Journals Online were searched for terms including "mental disorders", "neurotic disorders", "mood disorders" and "anxiety disorders". Studies published between 1990 and 2020 providing data on older people (≥50 years) in LMICs (defined by World Bank Criteria) were included and quality-assessed. Meta-analysis was conducted on a subset of higher-quality studies to derive pooled prevalence estimates of depression.</p><p>RESULTS: One hundred and forty relevant studies were identified, of which thirty-two were included in meta-analysis. One hundred and fifteen studies reported depression prevalence only, 19 reported both depression and anxiety, and six reported anxiety only. In all studies identified, depression prevalence ranged from 0.5 % to 62.7 %, and Generalised Anxiety Disorder prevalence ranged from 0.2 % to 32.2 %. The pooled prevalence of depression on meta-analysis was 10.5 % (95 % CI, 8.9 % - 11.2 %). Reported prevalence rates of depression were significantly different in studies using ICD-10 compared with DSM criteria, and between community and clinical settings.</p><p>LIMITATIONS: The search strategy contained bias towards English language papers and high income country (HIC) publications. There is significant heterogeneity within the meta-analysis.</p><p>DISCUSSION: A wide range of methodologies and clinical criteria are used in prevalence studies of depression and anxiety in older people. Studies using screening tools found higher prevalence rates; clinicians and researchers should ensure diagnosis is made with gold-standard clinical criteria. Meta-analysis data suggest that rates of depression are similar in older people in LMICs compared to HICs but mental healthcare resources are limited, suggesting a large potential treatment gap.</p>}},
  author       = {{Edwards, N and Walker, S and Paddick, S-M and Prina, A M and Chinnasamy, M and Reddy, N and Mboya, I B and Mtei, M and Varghese, M and Nakkasuja, N and Guerra, M and Sapkota, N and Dotchin, C}},
  issn         = {{0165-0327}},
  language     = {{eng}},
  month        = {{01}},
  pages        = {{656--674}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Affective Disorders}},
  title        = {{Prevalence of depression and anxiety in older people in low- and middle- income countries in Africa, Asia and South America : A systematic review and meta-analysis}},
  url          = {{http://dx.doi.org/10.1016/j.jad.2023.01.068}},
  doi          = {{10.1016/j.jad.2023.01.068}},
  volume       = {{325}},
  year         = {{2023}},
}