Depression and Disability: Comparisons with Common Physical Conditions in the Ibadan Study of Aging

Abstract

OBJECTIVES: To compare the effects of depression and chronic physical conditions on disability in elderly persons. SETTING: Yoruba‐speaking areas of Nigeria. DESIGN: Interviews. PATICIPANTS: Community‐dwelling persons aged 65 and older. METHOD: Face‐to‐face interviews were conducted with a representative sample of community‐dwelling persons aged 65 and older (N=2,152) in the Yoruba‐speaking areas of Nigeria (representing ∼22% of the national population). Major depressive disorder (MDD) was assessed using the World Health Organization Composite International Diagnostic Interview. Chronic pain and medical disorders were assessed using self‐report. Disorder‐specific disability was evaluated using the Sheehan Disability Scale (SDS). RESULTS: MDD was highly comorbid with each of the medical conditions (odds ratio range 1.3–2.0). A higher proportion of persons with MDD (47.2%) were rated severely disabled globally than those with arthritis (20.6%), chronic spinal pain (24.2%), or high blood pressure (25.0%). Subjects with MDD were also more likely to be severely disabled in three of the four domains of the SDS. In pair‐wise comparisons, persons with MDD had significantly higher levels of disability than those with any of the disorders, with differences in mean scores ranging between −3.74 and −27.50. CONCLUSION: To reduce the public health burden of depression, its prevention and treatment require more clinical and research attention than currently given by developing countries.