What does this research mean for the field?

The prevalence of depression in an elderly Hong Kong population is significantly associated with an increased number of chronic medical conditions and lower self-perceived socioeconomic standing. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

April 14, 2008Open Access

The influence of multi-morbidity and self-reported socio-economic standing on the prevalence of depression in an elderly Hong Kong population

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Depression (n=3394). Intervention: Multi-morbidity (number of chronic medical conditions). Primary outcome: Prevalence of depression (GDS score ≥ 8) (OR 1.27, 95% CI 1.16-1.39).

Key Result

The prevalence of depression in an elderly Hong Kong population was significantly associated with an increased number of chronic medical conditions (OR 1.27) and lower self-perceived socioeconomic standing.

Study Design

Type

Cross-Sectional (n=3,394)

Structured PICO

Population

3,394 men and women aged 65 years and over in Hong Kong, recruited as volunteers from a study on risk factors of osteoporosis.

Outcome

Prevalence of clinically relevant depressive symptoms (measured by the Geriatric Depression Scale with a cut-off score of 8)patient reported

In an elderly Hong Kong population, multi-morbidity and lower self-perceived socioeconomic standing are independently associated with a higher prevalence of clinically relevant depressive symptoms.

Main Result

Effect estimate: OR 1.27 (95% CI 1.16-1.39)

Limitations

Cross-sectional study design prevents establishing causal relationships between socioeconomic status, multi-morbidity, and depression.
Reliance on self-report for chronic medical conditions may lead to under-diagnosis or misclassification.
Use of a symptom scale (GDS) rather than clinical diagnosis for depression.

Abstract

BACKGROUND: There has been an increasing prevalence of both depression and chronic medical conditions globally but the relationship between depression and multi-morbidity is not well understood. The aim of the present study was to investigate the relationship between depression, multi-morbidity (number of chronic medical conditions, and measures of socioeconomic standing (SES) in an elderly Hong Kong population. METHODS: Cross sectional study. Information on clinically relevant depressive symptoms, measured by the Geriatric Depression Scale (GDS), and demographic and chronic medical conditions were collected using standardized questionnaires. Information collected on SES included educational status (ES), maximum ever income (MEI), and self-perceived social standing in local community (SES-COM) and in Hong Kong generally (SES-HK). Analysis was conducted using multiple logistic regression RESULTS: Depression rates were similar in men and women (GDS caseness 8.1% vs 8.4%). Multi-morbidity of chronic medical conditions was common (40% of men and 46% of women had three or more). In the overall sample, the prevalence of depression was associated with the number of chronic medical conditions (OR 1.27; CI: 1.16-1.39). In addition, SES-HK and SES-COM were significant independent variables. CONCLUSION: In this elderly Hong Kong population, depression prevalence rose markedly with number of chronic medical conditions and SES-HK and SES-COM.

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