Prevalence and Pattern of Psychiatric Morbidity Among Community-Dwelling Elderly Populations in Abeokuta,Nigeria

Abstract

Background:

Many elderly persons in Nigeria are having mental health challenges and there is a lack of commensurate increase in services to attend to such.

Aim:

To assess the prevalence, pattern and correlates of psychiatric morbidity among community dwelling elderly persons (≥ 60 years) in Abeokuta, Nigeria.

Methods:

532 respondents were selected using a multistage, stratified cluster sampling method from the elderly population in Abeokuta. First, participants were administered the socio-demographic questionnaire, General Health Questionnaire-12 (GHQ-12), and the Mini-Mental State Examination (MMSE). Those with a score of ≥ 3 in GHQ-12 were assessed with the Mini International Neuropsychiatric Interview (MINI PLUS), while those with ≤ 16 in MMSE were assessed with the Diagnostic Statistical Manual (DSM) IV criteria for Dementia and the Petersen’s criteria for Mild Cognitive Impairment (MCI).

Results:

36.3% of the respondents had a probable psychological disorder, while 25.4% had a probable cognitive impairment. 9.8% had a current definitive psychiatric disorder. The commonest disorders were major depressive disorder and dementia. The female gender, the oldest old (≥ 80 years), having a chronic medical illness and bereavement in the last 1 year were most significantly associated with having mental health problems.

Conclusion:

A significant number of the elderly population in the studied community suffers from a psychiatric illness. It is hoped that studies as these will inform stakeholders on the need to pay closer attention to the mental health needs of the elderly, as their overall wellbeing plays a role in determining the overall health of the community.

Keywords

elderly psychiatric morbidity dementia depression Nigeria

Get full access to this article

View all access options for this article.

References

World Health Organization. Are You Ready? What You Need to Know About Ageing. Geneva, Switzerland: World Health Day; 2012.

Rajan

. Population Ageing and Health in India. Mumbai, India: Centre for Enquiry into Health and Allied Themes; 2006.

Rogers

. Nigeria: The generic context of the boko haram violence. Monthly Global Security Briefing. Oxford Research Group; 2012: 1–5.

Baiyewu

Bella

Adeyemi

Bamgboye

Jegede

. Health problems and socio-demographic findings in elderly Nigerians. Afr J Med Med Sci. 1997;26(1-2):13–17.

Gureje

Lasebikan

Kola

Makanjuola

. Lifetime and 12-month prevalence of mental disorders in the Nigerian survey of mental health and well-being. Br J Psychiatry. 2006;188(5):465–471.

Tiwari

Srivastava

Tripathi

Pandey

Agarwal

Pandey

, et al. Prevalence of psychiatric morbidity amongst the community dwelling rural older adults in northern India. Indian J Med Res. 2013;138(4):504–514.

Copeland

Dewey

Wood

Searle

Davidson

McWilliam

. Range of mental illness among the elderly in the community. Br J Psychiatry. 1987;150(6):815–823.

Uwakwe

. Psychiatric morbidity in elderly patients admitted to non-psychiatric wards in a general/teaching hospital in Nigeria. Int J Geriatr Psychiatry. 2000;15(4):346–354.

Ajiboye

Yusuf

. Pattern of psycho geriatric disorders in a Nigerian outpatient psychiatric clinic. TropJ Health Sci. 2008;15(1):31–36.

10.

World Health Organization. Ageing: Exploding the Myths. Geneva, Switzerland: World Health Organization; 1999.

11.

Kowal

Dowd

. Definition of an Older Person. Proposed Working Definition of an Older Person in Africa for the MDS Project. Geneva, Switzerland: World Health Organization; 2001. doi:10.13140/2.1.5188.9286

12.

World Health Organization. World report on Ageing and Health.Geneva, Switzerland: World Health Organization; 2015.

13.

Hall

Ogunniyi

Hendrie

, et al. A cross-cultural community based study of dementias: methods and performance of the survey instrument Indianapolis, USA, and Ibadan, Nigeria. Int J Meth Psych Res. 1996;6(3):129–142.

14.

Ogunniyi

Baiyewu

Gureje

, et al. Epidemiology of dementia in Nigeria: results from the Indianapolis–Ibadan study. Eur J Neurol. 2000;7(5):485–490.

15.

Gureje

Kola

Afolabi

. Epidemiology of major depressive disorder in elderly Nigerians in the Ibadan study of ageing: a community-based survey. Lancet. 2007;370(9591):957–964.

16.

Baiyewu

Smith-Gamble

Lane

, et al. Prevalence estimates of depression in elderly community-dwelling African Americans in Indianapolis and Yoruba in Ibadan, Nigeria. Int Psychogeriatr.2007;19(4):679–689.

17.

Subedi

Tausig

Subedi

Broughton

Williams-Blangero

. Mental illness and disability among elders in developing countries: the case of Nepal. J Aging Health. 2004;16(1):71–87.

18.

National Population Commission. The 2006 population and housing census of the Federal Republic of Nigeria. Priority Tables. 2009; 1:22–39.

19.

National Population Commission. Nigeria Demographic and Health Survey 2013. 2014.

20.

Israel

. Determining Sample Size. Gainesvile, FL: University of Forida; 1992.

21.

Yusuf

Baiyewu

Sheikh

Shehu

. Prevalence of dementia and dementia subtypes among community-dwelling elderly people in northern Nigeria. Int Psychogeriatr. 2011;23(3):379–386.

22.

Goldberg

Gater

Sartorius

, et al. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med. 1997;27(1):191–197.

23.

Gureje

. Reliability and the factor structure of the Yoruba version of the 12-item General Health Questionnaire. Acta PsychiatrScand. 1991;84(2):125–129.

24.

Guruje

Unverzargt

Osuntokun

, et al. The CERAD Neuropsychological Test Battery: norms from a Yoruba-speaking Nigerian sample. West AfrJ Med. 1995;14(1):29–33.

25.

Sheehan

Lecrubier

Sheehan

, et al. The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59(suppl 20):22–33.

26.

Adewuya

Ologun

Ibigbami

.Post-traumatic stress disorder after childbirth in Nigerian women: prevalence and risk factors. BJOG. 2006;113(3):284–288.

27.

Rubino

Pezzarossa

Zanna

Ciani

. Foulds’ hierarchy: validation of predictions in psychiatric and dermatological patients. Br J Med Psychol. 1997;70(4):395–402.

28.

Petersen

Doody

Kurz

, et al. Current concepts in mild cognitive impairment. Arch Neurol. 2001;58(12):1985–1992.

29.

Brislin

. Back-translation for cross-cultural research. J Cross Cult Psychol. 1970;1(3):185–216.

30.

Tiwari

. Geriatric psychiatric morbidity in rural Northen India: implications for the future. Int Psychogeriatr. 2000;12(1):35–48.

31.

Andreas

Schulz

Volkert

, et al. Prevalence of mental disorders in elderly people: the European MentDis_ICF65+ study. Br J Psychiatry. 2017;210(2):125–131.

32.

World Health Organization. The World Health Report 2001: Mental Health: New Understanding, New Hope. Geneva, Switzerland: World Health Organization; 2001.

33.

Jeste

Blazer

First

. Aging-related diagnostic variations: need for diagnostic criteria appropriate for elderly psychiatric patients. Biol Psychiatry. 2005;58(4):265–271.

34.

Grenier

Préville

Boyer

, et al. The impact of DSM-IV symptom and clinical significance criteria on the prevalence estimates of subthreshold and threshold anxiety in the older adult population. Am J Geriatr Psychiatry. 2011;19(4):316–326.

35.

McManus

Bebbington

Jenkins

Brugha

. Mental Health and Wellbeing in England: Adult Psychiatric Morbidity Survey 2014: ASurvey Carried Out for NHS Digital by NatCen Social Research and the Department of Health Sciences, University of Leicester. Leeds, UK: NHS Digital; 2016.

36.

Olivera

Benabarre

Lorente

, et al. Detecting psychogeriatric problems in primary care: factors related to psychiatric symptoms in older community patients. Ment Health Fam Med. 2011;8(1):11–19.

37.

Schomerus

Matschinger

Angermeyer

. The stigma of psychiatric treatment and help-seeking intentions for depression. Eur Arch Psychiatry Clin Neurosci. 2009;259(5):298–306.

38.

Pilcher

. Women of their Time: Generation, Gender Issues and Feminism. London, UK Routledge; 2017.

39.

Sunderland

Anderson

Sachdev

Titov

Andrews

. Lifetime and current prevalence of common DSM-IV mental disorders, their demographic correlates, and association with service utilisation and disability in older Australian adults. Aust NZ J Psychiatry. 2015;49(2):145–155.

40.

Guerra

Prina

Ferri

, et al. A comparative cross-cultural study of the prevalence of late life depression in low and middle income countries. J Affect Disord. 2016;190:362–368.

41.

Mojtabai

Olfson

Han

. National trends in the prevalence and treatment of depression in adolescents and young adults. Pediatrics. 2016;138(6):e20161878.

42.

Cheng

. Late-life depression. In: Hategan

Bourgeois

Hirsch

Giroux

, eds. Geriatric Psychiatry. Cham, Switzerland: Springer; 2018:219–235.

43.

Uwakwe

. The pattern of psychiatric disorders among the aged in a selected community in Nigeria. Int J Geriatr Psychiatry. 2000;15(4):355–362.

44.

Hendrie

Osuntokun

Hall

Ogunniyi

. Prevalence of Alzheimer’s disease and dementia in two communities: Nigerian Africans and African Americans. Am J Psychiatry. 1995;152(10):1485–1492.

45.

Gureje

Ogunniyi

Kola

. The profile and impact of probable dementia in a sub-Saharan African community: results from the Ibadan Study of Aging. J PsychosomRes. 2006;61(3):327–333.

46.

Guerchet

M’Belesso

Mouanga

, et al. Epidemiology of dementia in two cities of central Africa: The EDAC multicenter epidemiological survey. Alzheimer’s & Dementia. J Alzheimer’s Assoc.2010;6(4):S473–S474.

47.

Longdon

Paddick

Kisoli

Dotchin

Gray

Dewhurst

, et al. The prevalence of dementia in rural Tanzania: a cross-sectional community-based study. Int J Geriatr Psychiatry. 2013;28(7):728–737.

48.

Ferri

Prince

Brayne

, et al. Global prevalence of dementia: a Delphi consensus study. Lancet. 2005;366(9503):2112–2117.

49.

Depp

Jeste

. Bipolar disorder in older adults: a critical review. Bipolar Disord. 2004;6(5):343–367.

50.

Beekman

Bremmer

Deeg

, et al. Anxiety disorders in later life: a report from the Longitudinal Aging Study Amsterdam. Int J Geriatr Psychiatry. 1998;13(10):717–726.

51.

Wolitzky-Taylor

Castriotta

Lenze

Stanley

Craske

. Anxiety disorders in older adults: a comprehensive review. Depress Anxiety. 2010;27(2):190–211.

52.

Miettunen

Immonen

McGrath

Isohanni

Jääskeläinen

. The Age of Onset of Schizophrenia Spectrum Disorders. In: de Girolamo

McGorry

Sartorius

, eds. Age of Onset of Mental Disorders. Cham, Switzerland: Springer; 2019:55–73.

53.

Castle

Murray

. The epidemiology of late-onset schizophrenia. Schizophr Bull. 1993;19(4):691–700.

54.

Johnson

. Alcohol problems in old age: a review of recent epidemiological research. Int J Geriatr Psychiatry. 2000;15(7):575–581.

55.

O’connell

Chin

A-V

Cunningham

Lawlor

. Alcohol use disorders in elderly people–redefining an age old problem in old age. BMJ. 2003;327(7416):664–667.