Old age and depression in Ghana: assessing and addressing diagnosis and treatment gaps
Date
2019-11-04
Journal Title
Journal ISSN
Volume Title
Publisher
GLOBAL HEALTH ACTION
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, we 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 some 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.
Description
Research Article
Keywords
Depression, prevalence, feasibility study, older adults, mental health, Africa
Citation
Peter Lloyd-Sherlock, Sutapa Agrawal, Mary Amoakoh-Coleman, Selasie Adom, Ebenezer Adjetey-Sorsey, Ilaria Rocco & Nadia Minicuci (2019) Old age and depression in Ghana: assessing and addressing diagnosis and treatment gaps, Global Health Action, 12:1, 1678282, DOI: 10.1080/16549716.2019.1678282