Old age and depression in Ghana: assessing and addressing diagnosis and treatment gaps

Peter Lloyd-Sherlock, Sutapa Agrawal, Mary Amoakoh-Coleman, Selasie Adom, Ebenezer Adjetey-Sorsey, Ilaria Rocco, Nadia Minicuci

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Abstract

Background:
There is limited evidence about the prevalence of depression among older people in sub-Saharan Africa, about access to treatment or the potential efficacy of community-based interventions.
Objective:
Using nationally representative data from the WHO SAGE survey, examine the prevalence of and factors associated with depression among people aged 50 and over in Ghana.
Compare self-reported diagnosis and a symptom algorithm to assess treatment gaps and factors associated with the size of gap.
Assess the feasibility of a small community-based intervention specifically for older people.
Method:
Prevalence and treatment data were taken from the WHO SAGE 2007 survey in Ghana, including 4,725 people aged 50 or over. Outcomes of interest were self-reported depression and diagnosis of depression derived from a symptom-based algorithm. The data were subjected to bivariate and multivariate analysis. In parallel, a pilot intervention was conducted with 35 older people, which included screening by a trained psychiatrist and follow-up group sessions of psychotherapy.
Results:
The symptomatic algorithm reported an overall rate of 9.2 per cent for the study population, with associations with female sex and older age. The treatment gap for these cases was found to be 83.0 per cent. The implementation of the pilot study was perceived as effective and replicable by stakeholders and there was so evidence of enhanced outcomes for people with mild depression.
Conclusions:
Large numbers of older people in Ghana experience depression, but very few have access to treatment. There is an urgent need to develop and validate community-based services for older people experiencing this condition.
Original languageEnglish
Article number1678282
JournalGlobal Health Action
Volume12
Issue number1
Early online date4 Nov 2019
DOIs
Publication statusPublished - 2019

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