Higher prevalence of geriatric depression, catastrophizing pain and sleep disorders in institutionalized elders: a cross-sectional study in Galle District, Sri Lanka

Abstract

Background: Population aging is a significant social problem in the twenty first century. Recent economic and social changes lead increasing number of elders to spend their lives in elderly homes. Institutionalized elders have to face many physical and psychological problems which negatively impact their quality of life. Geriatric depression (GD), catastrophizing pain (CP) and sleep disorders (SD) are some common problems among them.

Methods: Present study was designed to assess the prevalence of GD, CP and SD and their correlations in institutionalized elders. A descriptive cross-sectional study was conducted in elderly homes (n = 20) in the Galle district of Sri Lanka enrolling 310 subjects. GD, CP and SD were assessed using validated Sinhala versions of Geriatric Depression Scale (GDS), Pain Catastrophizing Scale (PCS) and Pittsburgh Sleep Quality Index (PSQI) respectively. Data were analyzed using SPSS version 25.0 for windows by using descriptive statistics, the Pearson's chi-square test and Pearson's bivariate correlation (p < 0.05).

Results: Among the participants (response rate: 95.7%), 34.8% (n = 108) and 65.2% (n = 202) were males and females respectively. Age range of the subjects was 60-103 years with the mean age of 74.97 years (SD 8.852). Most of the study subjects (n = 234, 75.5%) had spent five or less than 5 years in elderly homes at the time of the study and 52.8% (n = 164) of them were unmarried. GD was present in 76.5% (95% CI: 71.7-81.2) of subjects and of them 44% had moderate to severe depression. PCS revealed that 29% (95% CI: 24.0-34.1) had CP. SD were identified in 55.5% (95% CI: 49.5-61.0) of elders and according to PSQI, 86% (95% CI: 82.3-90.0) had poor quality sleep. Positive correlations between GD and CP (r = 0.24, p < 0.01), GD and SD (r = 0.13, p = 0.02), CP and SD (r = 0.32, p < 0.01) were statistically significant.

Conclusions: Prevalence of GD, CP and SD were significantly higher in this sample of institutionalized elders who were apparently healthy. Findings highlighted the importance of early screening of physical and psychological problems in institutionalized elders to assure better quality of life and to reduce the burden to health care system of the country.

Keywords: Catastrophizing pain; Correlation; Geriatric depression; Institutionalized elders; Sleep disorders; Sleep quality.