Depression, loneliness, and malnutrition among older people in Lalitpur, Nepal: findings from a 2014 community-based cross-sectional study

BackgroundAs Nepals older population grows and chronic health conditions become more common, the vulnerability of older adults has emerged as a major public health concern. This study assessed the key aspects of geriatric health--depression, loneliness, and malnutrition, along with the factors associated with depression--among older people living in the Lalitpur district, Nepal. MethodsThis study utilized a multistage cluster sampling technique, with probability proportionate to size, to select 360 participants aged 60 and older from the communities in Lalitpur, Nepal. Depression, loneliness, and nutritional status were assessed via the Geriatric Depression Scale (GDS), the Modified Jong-Gierveld scale, and the Mini Nutritional Assessment (MNA) tool, respectively. Statistical analysis was conducted using complex sample statistics, with the findings presented as percentages. To determine the relationships between variables, chi-square and F-tests were utilized. Furthermore, simple linear regression analysis with wild cluster bootstrapping was employed to identify factors associated with depression, with the results expressed as coefficients accompanied by 95% confidence intervals. ResultsIn the study population, 27% of the participants had depression, and 6.1% had severe depression. Approximately 67% were experiencing loneliness, and nearly 25% reported severe loneliness. Furthermore, about 48.9% were considered socially isolated. The prevalence of malnutrition and at risk of malnutrition was 13% and 45%, respectively. In the regression analysis adjusted for sex, family structure and marital status, a significant positive association was observed between depression and being female gender ({beta} = 0.11; 95%CI = 0.01 - 0.21), having financial dependency({beta} = 0.14; 95%CI = 0.00 - 0.27), at risk of malnutrition ({beta} = 0.20; 95%CI = 0.08 - 0.31) being malnourished ({beta} = 0.58; 95%CI = 0.45 - 0.72), having insomnia ({beta} = 0.22; 95%CI = 0.10 - 0.35), having smoking history ({beta} = 0.14; 95%CI = 0.00 - 0.28) and experiencing loneliness ({beta} = 0.34; 95%CI = 0.24 - 0.44). ConclusionThis study offers unique insights into the prevalence of depression, loneliness, and malnutrition among older adults living in Lalitpur district of Nepal, and key factors significantly associated with depressive: female gender, financial dependence on others, experiencing loneliness, having insomnia, smoking history and malnutrition. These findings underscore a critical requirement for comprehensive health screenings and targeted public health strategies to mitigate the primary wellness challenges faced by the aging population in the community.