"Background: Depression is a significant geriatric problem. It will be a major health problem in developing nations by the year 2020. Signs and symptoms of depression among elderly people are usually so unspecific that they are often considered as a part of getting old. No wonder so many elderly depression cases remain uncured. When depression is under-diagnosed, the various problems accompanied with it will make the bio-psychosocial condition of the patient worsen. There is no primary data on the prevalence of depression in the Indonesian elderly population, especially in Eastern Indonesian conflict areas.
Objective: The objective was to determine the prevalence and the severity of depression, as well as cognitive function in elderly subjects living in the conflict area in Buru Island, Maluku.
Design: This study was designed as a survey, conducted in the Northeast Buru Region, Maluku, from March to May 2003. Questionnaires on the validated Geriatric Depression Scale and Mini Mental State Evaluation were performed by trained native speaker paramedics for the identification of depression, the severity of depression, and cognitive function. The 401 elderly people that participated in this survey ranged in age from 60 to 120 years. As many as 215 (53.6%) were women, and 223 (55.6%) were uneducated.
Results: The prevalence of depression was 52.4%. A hundred and eighty seven subjects (94 females and 93 males) aged 60-120 years were in the mild depression category, and 23 subjects (14 females and 9 males) aged 60-85 years were severely depressed. While 82.6% elderly in severe depression category had an MMSE Score of less than 24 (dementia), 74.7% had mild depression, and only 57.1% of the elderly had no depression and received MMSE score less than 24. The majority of complaints among depression subjects were that they were bothered by thoughts they cannot get out of their head, they frequently worry about the future, they often became restless and fidgety, got bored, felt helpless, downhearted and blue, felt like crying, and that their life was empty. Seventy eight percents mild depressive elderly still enjoy getting up in the morning and 68% were hopeful about the future, which was on the contrary to the subjects with severe depression, where only 35% had these two positive outlooks.
Conclusions: The prevalence of depression in Buru Island community was high, even though most of them were in the mild depression category. The worse the depression, the higher the percentage of cognitive impairment. There was still enough willingness to get better among subjects with mild depression. We need to think about the possibility of Post Traumatic Stress Disorder in the elderly population of this conflict area.
Suggestions: Medical practitioners in conflict areas need to increase their awareness of depression and cognitive impairment among elderly people. Geriatrician and psychogeriatric experts are needed to ensure that the problem of depression in the elderly does not worsen in conflict areas. Further studies are needed to detect Post Traumatic Stress Disorder."
