Multilevel Analysis of Factors Affecting Depression Risk among the Elderly: Loneliness, Living Status, Physical Activity, Age, Gender, and Education
DOI:
https://doi.org/10.26911/jepublichealth.2024.09.04.11Abstract
Background: There is still a high prevalence of depression in the elderly which is affected by loneliness, low physical activity, gender, last education, and residence status. Elderly people who live alone or have lost a life partner are more prone to depression. Although family support and public health services such as Posyandu are expected to protect against the risk of depression, there have not been many studies that have examined in depth the influence of Posyandu as a contextual factor in reducing the risk of depression in the elderly. This study aims to analyze the influence of these factors and the role of Posyandu in reducing the risk of depression.
Subjects and Method: This study used a cross-sectional design conducted in 25 Posyandu Elderly in Grogol District, Sukoharjo Regency from August to September 2024. A total of 204 elderly respon-dents aged 60 years and above were selected using Stratified Random Sampling. The dependent variable in this study was depression collected using the PHQ-9 questionnaire, and loneliness was assessed by the UCLA Loneliness Scale. Other independent variables such as physical activity, gender, education, and life status were collected through structured interviews. Multilevel linear regression analysis is used to analyze the relationship between these factors and the risk of depression, taking into account the individual and contextual levels (Posyandu).
Results: The average age of the respondents was 66.27 years old (Mean = 66.26, SD = 5.16), with 79.41% of them being female. Loneliness was significantly associated with an increased risk of depression (b= 0.05; CI 95%= 0.07 to 0.10; p=0.024), while living with family reduces the risk of depression (b= -6.33; CI 95%= -8.26 to -4.40; p<0.001). Physical activity did not show a significant association with depression. Gender, education level, and age are also not significant predictors of depression. Contextual speaking, posyandu has no effect as a contextual variable on the variable of depression in the Grogol sub-district (ICC=2.64%).
Conclusion: Loneliness is a significant risk factor for depression in the elderly while living with family also reduces the risk of depression in the elderly.
Keywords:
Elderly, depression, loneliness, housing status, multilevel analysis, physical activityCorrespondence
Emirza Nur Wicaksono. Master’s Program in Public Health, Universitas Sebelas Maret. Jl. Ir Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: emirza.wicaksono@gmail.com. Mobile: +6281770247207.
References
Afrizal (2018). Problems experienced by the elderly in adjusting to the mastery of their developmental tasks (Permasalahan yang dialami lansia dalam menyesuaikan diri terhadap penguasaan tugas-tugas perkembangannya). J Bimbingan dan Konseling Islam. 2(2)
Chu W, Chang SF, Ho H, Lin HC (2019). The relationship between depression and frailty in community-dwelling older people: A systematic review and meta-analysis of 84,351 older adults. J Nurs Scholarsh. 51(5): 547–559. doi:10.1111/jnu.12501.
Darmawan MD (2019). An overview of the level of depression in the elderly living in the Karanganyar Healthy Griya Bahagia Home (Gambaran tingkat depresi pada lansia yang tinggal di Panti Griya Sehat Bahagia Karang-anyar). Naskah Publikasi UMS. 19(2): 1–11.
Fazila F, Khairani (2018). Characteristics and levels of depression in the elderly (Karakteristik dan tingkat depresi lanjut usia). Idea Nursing J. 9(2)
Fitriana L, Lestari DR, Rahmayanti D (2021). The relationship between physical activity and the level of loneliness in the elderly in the Banjarmasin Happy Elderly Institution (Hubungan antara aktivitas fisik dengan tingkat kesepian pada lansia di Karang Lansia Bahagia Banjarmasin). Nusantara Hasana J. 1(1): 95–101. doi: 10.20527/dk.v9i2.6544.
Hindriyastuti S, Safitri F (2022). The relationship between loneliness and depression in the elderly at the Geritan Village Elderly Posyandu, Panti District (Hubungan kesepian dengan tingkat depresi pada lansia di Posyandu Lansia Desa Geritan Kecamatan Panti). J Profesi Keperawatan. 9(2): 110–126.
Kadariya S, Gautam R, Aro AR (2019). Physical activity, mental health, and well-being among older adults in South and Southeast Asia: A scoping review. BioMed Res Int. 2019: 6752182. doi: 10.1155/2019/6752182.
Kementerian Kesehatan RI (2014). Situation and analysis of the elderly (Situasi dan analisis lanjut usia). Jakarta: Kementerian Kesehatan RI.
Kementerian Kesehatan RI (2021). General guidelines for posyandu services. Jakarta: Kementerian Kesehatan RI.
Kurniawan YF (2022). Depression in the elderly (Depresi pada lansia). J Holist Tradit Med. 6(4).
Liu Y, Meguro K, Nakamura K, Akanuma K, Nakatsuka M, Seki T, Kawakami N, et al. (2017). Depression and dementia in old population: History of depression may be associated with dementia onset. Front Aging Neurosci. doi: 10.3-389/fnagi.2017.00335.
Lutviana ES (2017). The relationship between coping mechanism and sub-projective well-being in the elderly in Pstw Yogyakarta, Budi Luhur unit. J Keperawatan Respati Yogyakarta. 198–203.
Mahindru A, Patil P, Agrawal V (2023). Role of physical activity on mental health and well-being: A review. Cureus. 15(1): e33475. doi: 10.7759/cureus.33475.
Manuntung A (2018). Cognitive behavioral therapy in hypertensive patients (Terapi perilaku kognitif pada pasien hipertensi). Malang: Penerbit Wineka Media.
Mumulati SB, Nirman S (2020). Relationship of education, age, gender, marital status, and long stay at nursing homes with depression events in elderly. J Kesehatan Jiwa. 8(3): 329–336. doi: 10.26714/jkj.8.3.2020.329336.
Ngadiran A (2020). The relationship between characteristics (age, education, and length of stay in the orphanage) with the level of anxiety of the elderly (Hubungan karakteristik (umur, pendidikan, dan lama tinggal di panti) dengan tingkat kecemasan lansia). J Ilmu Kesehatan Immanuel. 13: 104. doi:10.36051/jiki.v13i2.95.
Putri RP (2016). The relationship between social participation and loneliness in the elderly (Hubungan partisipasi sosial dengan kesepian pada lansia). Universitas Muhammadiyah Malang. Skripsi.
Prabandari FI (2021). The relationship between physical activity and depression and quality of life in the elderly. Universitas Sebelas Maret.
Rahmawati AR, Wisnusakti K, Bolla IN (2023). The relationship between loneliness and depression in the elderly at the UPTD Griya Elderly Social Service Center Hubungan tingkat kesepian dengan depresi pada lansia di UPTD Pusat Pelayanan Sosial Griya Lansia). 18(2): 80–87.
Sadock BJ, Sadock VA, Ruiz P (2015). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry. 11th ed. Philadelphia, PA: Wolters Kluwer.
Sutinah, Maulani (2017). The relationship between education, gender and marital status with depression in the elderly (Hubungan pendidikan, jenis kelamin dan status perkawinan dengan depresi pada lansia). J Endurance. 2(June): 209–216. doi: 10.22216/jen.v2i2.1931.
Tristian D, Murti B, Demartoto A (2024). Multilevel analysis: Factors related with quality service of elderly community health post in Sukoharjo Central Java. J Epidemiol Public Health. 9(2): 170–177. doi: 10.26911/-jepublichealth.2024.09.02.04.
Zhang Y, Kuang J, Wang X, Li H, Zhao F, Liu L, Chen R, et al. (2023). Loneliness, social isolation, depression, and anxiety among the elderly in Shanghai: Findings from a longitudinal study. Arch Gerontol Geriatr. 110: 104980. doi: 10.1016/j.archger.2023.104980.
Downloads
Published
2024-10-16
Issue
Vol. 9 No. 4 (2024)
Section
Articles
1.jpg)
