The Impact of Anxiety, Depression & Cognitive Impairment on Functioning in the Physically Ill Elderly in Egypt

The Impact of Anxiety, Depression & Cognitive Impairment on Functioning in the Physically Ill Elderly in Egypt

Hamza S, Haroun El Rasheed A, Kahla O

Current Psychiatry Vol. 13 No.2 July 2006

Abstract

In the elderly, depression as well as anxiety are often under-diagnosed in medical settings or simply dismissed as inevitable consequences of aging or unavoidable complication of other illnesses or treatments. So, this study was set out to detect the common psychological problems in an Egyptian sample of the physically ill elderly. Depression, anxiety state/trait and cognitive dysfunction and their relation to various medical problems as well as their impact on the different forms of functioning were studied. One hundred elderly patients recruited from the inpatient unit as well as the outpatient clinic in the Geriatric Medicine Department, Ain Shams University Hospitals, were assessed using Instrumental Activities of Daily Living (IADL), Activities of Daily living (ADL), health promotion questionnaire, Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS, 30 items), State-Trait Anxiety Inventory (STAI), as well as assessment for the different medical conditions. Only 26% had mild cognitive impairment according to MMSE, 64% were severely depressed according to GDS & 72% were suffering from anxiety as assessed by STAI & 35% had anxiety trait by the same scale. Moreover, 47% were dependant as regards IADL and 26% as regards ADL. Neither depression nor anxiety trait were associated with any sociodemographic or clinical variables (P>0.05). However, it was found that functional impairment on IADL was significantly associated with depression (X²=4.496, P=0.028), and functional impairment on ADL showed a highly significant association with depression and anxiety trait (X²=13.167, P<0.001 for both).

Regardless of their cause, depression as well as anxiety should be disentangled from any other disorder, particularly from physical disorders, so that the most appropriate treatment can be prescribed as timely intervention can reduce the incidence of undesirable consequences including suicide.

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