Contextual effect on mental health among elderly people in rural Kanchanaburi DSS, Thailand

Abstract

Global population is ageing and Thailand has one of the fastest growing ageing populations in this region. Combined with this, depression has become a major mental health problem for older people. Contextual characteristics often play a significant role on the mental health of older people. However, research on contextual influence on older adult's mental health, specifically, is limited. The objective of this study was to investigate whether contextual characteristics have an effect on the mental health of older people living in Kanchanburi Demographic Surveillance System (KDSS), Thailand. The data were used from 'Survey on health and social support among the older adults' in KDSS' in 2006, and 'Survey on migration and health in KDSS' in 2005'. Depression was measured by a 12 item questionnaire of Thai validated Euro-D scale among 1001 respondents. The questions were on depression, pessimism, wishing to die, guilt, sleep disturbance, loss of interest, irritability, eating problems, fatigue, problem in concentration, lack of enjoyment, and tearfulness. Among the respondents 28.5% had depression. Univariate, bivariate, and multivariate analysis (logistic regression) and multilevel analysis were done. Contextual characteristics (village infrastructure, environmental problems, and community development programs) did not affect the depression of the elderly people significantly living in KDSS area. Individual characteristics such as female gender, infirmity, disability, and serious life events significantly affected the mental health of older people along with the household characteristics of living with grandchildren.