Factors Related to Depression among Older Adults in Areas of Health Region 5
Keywords:
depression; Health Region 5; older adults; predictive factorsAbstract
Depression among the elderly is linked to multiple causes; however, it remains unclear which factors serve as significant predictors. This study employed an explanatory sequential mixed-methods design to investigate the levels of depression, its predictive factors, and the qualitative characteristics of those predictors. The sample consisted of 480 elderly individuals in Health Region 5, selected through stratified random sampling at the district, sub-district, and household levels. For the qualitative phase, 30 participants with depression were selected using purposive sampling. Research instruments included a Personal Information Questionnaire, Family Relationship Questionnaire, Social Participation Questionnaire, Insomnia Assessment Scale, Suanprung Stress Test, and the Thai Geriatric Depression Scale (TGDS). The instruments demonstrated reliability with Cronbach’s alpha coefficients of .80, .82, .85, and .80 and a KR-21 coefficient of .83, respectively. Data collection took place from November 1, 2024, to April 6, 2025. Quantitative data were analyzed using frequency, percentage, mean, standard deviation, and multiple regression analysis, while qualitative data were analyzed using thematic analysis. The quantitative results revealed an average depression score of 5.07 (SD=1.57), which, according to the assessment criteria, indicates no clinical depression. The independent variables collectively predicted depression by 68% (Adj R2=.68, p<.001). The significant predictors, in order of influence, were social participation, family relationships, insomnia, and stress (β=–.45, -.20, .15, and .11, respectively). Qualitative findings characterized these predictive factors through themes of family conflict, feeling lonely, despondency related to insomnia, and stress from life problems. The findings of this study highlight the factors influencing depression among the elderly, which relevant personnel should take into consideration when implementing interventions aimed at reducing depression in this population.
References
Department of Provincial Administration, Ministry of Interior. Statistics of elderly population in Thailand, 2024 [Internet]. 2024 [cited 2025 Aug 17]. Available from: https://stat.bora.dopa.go.th.
Ministry of Public Health. Health Data Center (HDC) [Internet]. 2024 [cited 2025 Aug 17]. Available from: https://hdcservice.moph.go.th.
Charoensakulchai S, Usawachoke S, Kongbangpor W, Thanavirun P, Mitsiriswat A, Pinijnai O, et al. Prevalence and associated factors influencing depression in older adults living in rural Thailand: A cross-sectional study. Geriatr Gerontol Int [Internet]. 2019 [cited 2025 Sep 20];19(12):1248-53. Available from: https://doi.org/10.1111/ggi.13804.
Siriwannakultorn I, Jiraporncharoen W, Pinyopranpanich K, Angkurawaranon C, Rojanasumapong A, Inpa C, et al. Prevalence and related factors of depression in the elderly: Outpatient family medicine clinic, Maharaj Nakorn Chiang Mai Hospital. J Mental Health Thai [Internet]. 2021 [cited 2025 Sep 29];29(1):1-11. Available from: https://he01.tci-thaijo.org/index.php/jmht/article/view/244111/168163. (in Thai)
Naviganuntana Y, Kerdcharoen N, Rawdaree P. Factors associated with depressive symptoms in elderly individuals living in urban communities. Psychol Res Behav Manag [Internet]. 2022 [cited 2025 Sep 29];15:855-64. Available from: https://doi.org/10.2147/PRBM.S348782. (in Thai)
Kotayan P, Srisuwan P, Kengpanich S. Prevalence and associated factors of depression among older adults in primary care unit at Phramongkutklao Hospital. J Prev Med Assoc Thai [Internet]. 2021 [cited 2025 Sep 25];11(1):30-49. Available from: https://he01.tci-thaijo.org/index.php/JPMAT/article/view/246300. (in Thai)
Gao Y, Jia Z, Zhao L, Han S. The effect of activity participation in middle-aged and older people on the trajectory of depression in later life: National cohort study. JMIR Public Health Surveill [Internet]. 2023 [cited 2025 Sep 29];9:e44682. Available from: https://doi.org/10.2196/44682.
Choi E, Han KM, Chang J, Lee YJ, Choi KW, Han C, et al. Social participation and depressive symptoms in community-dwelling older adults: Emotional social support as a mediator. J Psychiatr Res [Internet]. 2021 [cited 2025 Sep 20];137:589-96. Available from: https://doi.org/10.1016/j.jpsychires.2020.10.043.
Thamcharoen W, Charoengam N, Chotidilok Y, Thongnunui N. Factors related to depression of the elderly. Rajabhat Rambhai Barni Res J [Internet]. 2021 [cited 2025 Dec 5];15(3):52-62. Available from: https://so05.tci-thaijo.org/index.php/RRBR/article/view/256388. (in Thai)
Sattapisit S, Wongpakaran T, Nakaviro D, Hiranthep T, Wongpakaran N, Pukkaman P, et al. Types of insomnia and effects of insomnia on treatment of patients with depression. J Psychiatr Assoc Thai [Internet]. 2017 [cited 2025 Sep 20];62(1):47-55. Available from: http://www.psychiatry.or.th/JOURNAL/62-1/05%20Sirina(1).pdf. (in Thai)
Beniusiene A, Kontautiene V, Strukcinskiene B, Grigoliene R, Martisauskiene D, Jurgaitis J. Depression, anxiety, and stress symptoms (DASS-21) in elderly women in association with health status (SHSQ-25): A cross-sectional study. Healthcare [Internet]. 2025 [cited 2025 Dec 10];13(1):1-21. Available from: https://doi.org/10.3390/healthcare13010007.
Lee J, Lee J, Hwang S, Chung MK, Park JY, Shin T, et al. Longitudinal examination of stress and depression in older adults over a 2-year period: Moderation effect of varied social support measures. Int J Environ Res Public Health [Internet]. 2024 [cited 2025 Sep 20];21(9):1201. Available from: https://doi.org/10.3390/ijerph21091201.
Painikphan W, Permpool B, Wichaiyo W. Factors affecting risk of depression among the elderly in Yod Kaeng Subdistrict, Na Mon District, Kalasin Province. J Environ Health Community Health [Internet]. 2019 [cited 2025 Sep 20];4(1):11–23. Available from: https://he03.tci-thaijo.org/index.php/ech/article/view/201217. (in Thai)
Beck AT. Depression: Clinical, experimental, and theoretical aspects. New York: Harper & Row; 1967.
Samranchai R. A study of family relationship and adaptation of menopausal women in Satahip Naval Base, Chonburi Province [Master's thesis]. Bangkok: Mahidol University; 1997. (In Thai)
Rojanadhamkul N, Klommek J, Sriratanaprapat J. Social activities participation of elder persons in Muak Lek Subdistrict, Muak Lek District, Saraburi Province. J Health Nurs Res [Internet]. 2020 [cited 2025 Sep 20];36(2):15-25. Available from: https://he01.tci-thaijo.org/index.php/bcnbangkok/article/view/244312/165829. (in Thai)
Keawphang P. Relationships between selected factors and insomnia in adult cancer patients [Master's thesis]. Bangkok: Chulalongkorn University; 2004 [cited 2025 Dec 1]. Available from: https://digiverse.chula.ac.th/Info/item/dc:27508. (in Thai)
Mahatnirunkul S, Pumpaisalchai W, Tapanya P. Development of Suanprung Stress Test-20 [Research report]. Chiang Mai: Suanprung Hospital; 1997. (in Thai)
Wongpakaran N, Wongpakaran T. Prevalence of major depressive disorders and suicide in long-term care facilities: a report from northern Thailand. Psychogeriatrics [Internet]. 2012 Mar [cited 2025 Sep 20];12(1):11-7. Available from: https://doi.org/10.1111/j.1479-8301.2011.00383.x.
Harrington MO, Reeve S, Bower JL, Renoult L. How do the sleep features that characterize depression impact memory? Emerg Top Life Sci [Internet]. 2023 [cited 2025 Dec 5];7(5):499–512. Available from: https://doi.org/10.1042/ETLS20230100.
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