Sintomas depressivos em pessoas idosas alagoanas: prevalência e fatores associados

Abstract

Depressive symptoms are among the greatest challenges in global health management, imposing great concern and expenditure on health services. Depression negatively affects several individual aspects, and is mainly characterized by a decline in mood. With a multifactorial etiology, this condition can be determined by several aspects, among which are demographic and social characteristics, presence of comorbidities, functional capacity and the environment surrounding the residences. With regard to the elderly, there is an aggravating factor, considering that the presence of depressive symptoms can be confused with frequent mood changes in the aging process, making early diagnosis difficult. Thus, this study aims to identify the occurrence of depressive symptoms in elderly people living in the community in the state of Alagoas, as well as to evaluate the factors associated with this condition. The population-based cross- sectional study, composed of elderly people (≥60 years old), is an integral part of the research “I Alagoas Diagnosis on Health, Nutrition, and Quality of Life of the Elderly”. Data collection was carried out through home visits using a previously established questionnaire, between April 2022 and January 2024. The final sample consisted of 945 elderly people residing in eleven municipalities of Alagoas. The presence of depressive symptoms was investigated using the Geriatric Depression Scale (GDS-15), with values ≥5 points being adopted to define the presence of these symptoms. Information was also collected, through self-report, on the presence of chronic diseases such as Diabetes Mellitus (DM), cataracts, cancer, Systemic Arterial Hypertension (SAH) and cardiovascular diseases (presence/absence). Functional capacity was assessed using 3 items: (i) Katz Index, an instrument used to analyze functional independence; (ii) Handgrip Strength (HGS) – preserved or low; and (iii) Gait Speed (GS) – preserved or reduced. The environment surrounding the residences for practicing physical activity was assessed through the participants' perception of the aspects of having green areas near the home, car traffic as an objection to practicing physical activity, and the nighttime safety of public roads for these same practices. Multilevel logistic regression models examined the odds ratio of depressive symptoms according to the variables analyzed, considering both the effects of the municipality and the individual effects. The research was approved by the Research Ethics Committee (CEP) of the Federal University of Alagoas (CAAE: 39960320.2.0000.5013). The prevalence of depressive symptoms among the elderly was 36.6%. The following remained in the model, associated with depressive symptoms: having a diagnosis of DM (OR: 1.63, CI: 1.06- 2.49) and cataract (OR: 1.76, CI: 1.17-2.66), as well as having functional dependence to perform basic activities of daily living (OR: 6.70, CI: 1.21-37.14), low HGS (OR: 2.44, CI: 1.50-3.97), and reporting heavy traffic as a component that hinders the practice of physical activity (OR: 1.71, CI: 1.14-2.56). Thus, we observed that regardless of the characteristics of the individual and the municipality in which they reside, depressive symptoms in elderly people were associated with chronic diseases, reduced functional capacity, and the perception of the built environment for the practice of physical activity.