Factors Associated with Depression in Elderly Patients with Hypertension
DOI:
https://doi.org/10.33755/jkk.v11i4.934Keywords:
Depression, Elderly, HypertensionAbstract
Background: Depression in elderly individuals with hypertension is a common but often underdiagnosed mental health issue that affects quality of life and treatment adherence. This study aimed to identify factors associated with depression in elderly patients with hypertension.
Design : A descriptive correlational study with a cross-sectional design was conducted.
Methods : This study involved 68 community-dwelling elderly patients with hypertension in a village of North Sulawesi selected through total sampling. Data were collected using structured questionnaires covering sociodemographic and clinical characteristics and the Geriatric Depression Scale-15 (GDS-15). Data were analyzed using the Mann-Whitney U test, Kruskal-Wallis H test, and Spearman’s rank correlation.
Results : The mean depression score was 9.43 (SD = 1.79), with nearly half of participants experiencing moderate depression (48.5%). Only the duration of hypertension was significantly correlated with depression score (r = 0.275, p = 0.023).
Conclusions : These findings highlight the need for routine depression screening among elderly hypertensive patients, particularly those with a longer history of illness. Clinical implications include adopting integrated care models that combine hypertension management with psychosocial support in primary care settings
References
1. Chen LK. Urbanization and population aging: Converging trends of demographic transitions in modern world. Arch Gerontol Geriatr. 2022;101:104709.
2. Cunningham C, O’ Sullivan R, Caserotti P, Tully MA. Consequences of physical inactivity in older adults: A systematic review of reviews and meta-analyses. Scand J Med Sci Sports. 2020 May;30(5):816–27.
3. World Health Organization (WHO). Depressive disorder (depression). 2023.
4. Zenebe Y, Akele B, W/Selassie M, Necho M. Prevalence and determinants of depression among old age: A systematic review and meta-analysis. Ann Gen Psychiatry. 2021 Dec;20(1):55.
5. Handajani YS, Schröder-Butterfill E, Hogervorst E, Turana Y, Hengky A. Depression among older adults in Indonesia: Prevalence, role of chronic conditions and other associated factors. Clin Pract Epidemiol Ment Heal. 2022;18(1):1–10.
6. Nurhidayati I, Sulistyowati AD, Hamranani SST, Paramita SR. The effect of increased blood pressure on the decreasing quality of life of elderly people with hypertension. J Keperawatan Respati Yogyakarta. 2023;10(1):34–9.
7. Lewington S, Lacey B, Clarke R, Guo Y, Kong XL, Yang L, et al. The burden of hypertension and associated risk for cardiovascular mortality in China. JAMA Intern Med. 2016 Apr;176(4):524.
8. Mills KT, Bundy JD, Kelly TN, Reed JE, Kearney PM, Reynolds K, et al. Global disparities of hypertension prevalence and control: A systematic analysis of population-based studies from 90 countries. Circulation. 2016 Aug;134(6):441–50.
9. Turana Y, Tengkawan J, Chia YC, Shin J, Chen CH, Park S, et al. Mental health problems and hypertension in the elderly: Review from the HOPE Asia network. J Clin Hypertens. 2021;23(3):504–12.
10. Putra ICS, Tanjung JE, Dara M. The association between hypertension and depression in aged nursing home resident in Indonesia. J Hypertens. 2021 May;39(Supplement 2):e7–8.
11. Liu Q, Wang H, Liu A, Jiang C, Li W, Ma H, et al. Adherence to prescribed antihypertensive medication among patients with depression in the United States. BMC Psychiatry. 2022 Dec;22(1):764.
12. Gan Q, Yu R, Lian Z, Yuan Y, Li Y, Zheng L. Unraveling the link between hypertension and depression in older adults: A meta-analysis. Front Public Heal. 2023 Nov;11(November):1302341.
13. Sandström YK, Ljunggren G, Wändell P, Wahlström L, Carlsson AC. Psychiatric comorbidities in patients with hypertension a study of registered diagnoses 2009-2013 in the total population in Stockholm County, Sweden. J Hypertens. 2016 Mar;34(3):414–20.
14. Gabriel A, Zare H, Jones W, Yang M, Ibe CA, Cao Y, et al. Evaluating depressive symptoms among low-socioeconomic-status African American women aged 40 to 75 years with uncontrolled hypertension: A Secondary analysis of a randomized clinical trial. JAMA Psychiatry. 2021 Apr;78(4):426–32.
15. Ministry of Health of The Republic of Indonesia. Hasil riset kesehatan dasar tahun 2018 (result of national basic health research 2018). Jakarta; 2018.
16. Turana Y, Suswanti I, Barus JF, Suryakusuma L. Prevalence and risk factors of hypertension in elderly: Secondary analysis Indonesian Family Life Survey (IFLS). J Hypertens. 2021 May;39(Supplement 2):e17.
17. Cui H, Xiong Y, Wang C, Ye J, Zhao W. The relationship between BMI and depression: A cross-sectional study. Front Psychiatry. 2024 Oct;15(October):1–9.
18. Chowdhury EK, Berk M, Nelson MR, Wing LMH, Reid CM. Association of depression with mortality in an elderly treated hypertensive population. Int Psychogeriatrics. 2019;31(3):371–81.
19. Burnier M. Drug adherence in hypertension. Pharmacol Res. 2017;125(November):142–9.
20. Farhadi A, Javadian H, Vahedparast H, Marzban M, Nemati R, Larijani B, et al. Association between depression and blood pressure in community-dwelling older adults: Focus on Bushehr Elderly Health (BEH) program. BMC Public Health. 2023;23(1):1–10.
21. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, et al. Development and validation of a geriatric depression screening scale: A preliminary report. J Psychiatr Res. 1982;17(1):37–49.
22. Pramesona BA, Taneepanichskul S. Prevalence and risk factors of depression among Indonesian elderly: A nursing home-based cross-sectional study. Neurol Psychiatry Brain Res. 2018;30(April):22–7.
23. Ademola A, Boima V, Odusola A, Agyekum F, Nwafor C, Salako B. Prevalence and determinants of depression among patients with hypertension: A cross-sectional comparison study in Ghana and Nigeria. Niger J Clin Pract. 2019;22(4):558–65.
24. Kabutoya T, Kario K. Depression in hypertension and blood pressure variability over shorter time periods. Hypertens Res. 2015;38(11):713–5.
25. Li Z, Li Y, Chen L, Chen P, Hu Y. Prevalence of depression in patients with hypertension: A systematic review and meta-analysis. Medicine (Baltimore). 2015 Aug;94(31):e1317.
26. Zong L, Shi H, JIng J, Zhang X. Study on prevalence and correlates of depressive symptoms among patients with essential hypertension from 4 tertiary general hospitals in Guangzhou City and Ningbo City. Med Soc. 2016;29(71):71–4.
27. Ma C. The prevalence of depressive symptoms and associated factors in countryside dwelling older Chinese patients with hypertension. J Clin Nurs. 2018;27(41):2933–41.
28. Xue J, Chen S, Bogner HR, Tang W, Li L, Conwell Y. The prevalence of depressive symptoms among older patients with hypertension in rural China. Int J Geriatr Psychiatry. 2017 Dec;32(12):1411–7.
29. Ma L, Tang Z, Sun F, Diao L, Li Y, Wang J, et al. Risk factors for depression among elderly subjects with hypertension living at home in China. Int J Clin Exp Med. 2015;8(2):2923–8.
30. Asmare Y, Ali A, Belachew A. Magnitude and associated factors of depression among people with hypertension in Addis Ababa, Ethiopia: A hospital based cross-sectional study. BMC Psychiatry. 2022 May;22(1):327.
31. Ji K, Bai Z, Tang L, Yan H, Zhu Y, Chen G, et al. Institutional satisfaction and anxiety mediate the relationship between social support and depression in hypertension patients in elderly caring social organizations: A cross-sectional study. Front Psychol. 2021;12(October):772092.
32. Ruan J, Xu YM, Zhong BL. Depressive disorders in older Chinese adults with essential hypertension: A classification tree analysis. Front Cardiovasc Med. 2022 Oct;9(October):1–8.
33. Li Y, Fan Y, Sun Y, Alolga RN, Xiao P, Ma G. Antihypertensive drug use and the risk of depression: A systematic review and network meta-analysis. Front Pharmacol. 2021 Nov;12(November).
34. Andrade C. β-Blockers and the risk of the new-onset depression: Meta-analysis reassures, but the jury is still out. J Clin Psychiatry. 2021 Jun;82(3):21f14095.
