A systematic review on the prevalence of depression among the elder population in urban and rural communities of Asian countries

Abstract

Background Depression is a common psychiatric disease that affects the elder population in the world. The elderly with depression untreated will have a high tendency of getting sick, indulging in drug and alcohol or even attempting suicide. A common perspective is that rural communities are often under poor living conditions, with low income and education level so that people living there are more prone to depression than people living in the urban area. However, a study revealed that in Asian countries, the prevalence of depressive symptoms in the elderly was higher in urban than rural areas. In this systematic review, the prevalence of depression in urban and rural areas of the same Asian countries will be studied and compared. An overview of depression-associated factors such as literacy status and living arrangement for these cases will be considered.

Method It was a systematic review. Studies published between 1999 and 2016 were covered under this study. The prevalence of depression in respective cases for both urban and rural areas of the same country was compared. The available data of depression-associated factors such as literacy status and the living arrangement were retrieved in these cases for further study. In most of the reviewed cases, the Geriatric Depression Scale was used to assess the presence of depression for individual participants.

Results In India, the prevalence of depression in urban and rural areas was 39.1% (95% CI: 32.6% - 45.9%) and 47.0% (95% CI: 42.1% - 51.9%) respectively. In Japan, the prevalence of depression in urban and rural areas was 28.2% (95% CI: 25.5% - 30.8%) and 24.7% (95% CI: 22.1% - 27.3%) respectively. In Malaysia, the prevalence of depression in urban and rural areas was 19.2% (95% CI: 17.4% - 22.9%) and 27.8% (95% CI: 22.0% - 33.6%) respectively. In Saudi Arabia, the prevalence of depression in urban and rural areas was 36.4% (95% CI: 35.1% - 37.7%) and 44.0% (95% CI: 42.0% - 45.9%) respectively.

Conclusion From the summary of the nine studies presented in the current study, the case of Karnataka with small sample size is neglected. Except for the case of Kumamoto Prefecture in Japan which shows similar values of prevalence of depression in urban and rural areas, the results of remaining cases in India, Malaysia and Saudi Arabia provide evidence that the prevalence of depression is higher among the rural population than the urban population.