EPIDEMIOLOGY OF SELF-DEPENDENCE AMONG KUWAITI ELDERLY POPULATION OF ABDULLAH AL-SALEM AREA

important for primary care physicians to be aware of the symptoms of depression, as it may present with only simple sleep disturbances. It is often under-diagnosed and/or under-recognized by primary care physicians[18,21]. A large number of studies assessing the relationship between depression and medical burden have focused on patients with cardiac diseases, and recent researches have focused on the role of depression as an independent risk factor for cardiac disease [16,17,21]. Of morbidity identified within this population, the majority take two or more medications daily [12,13]. The prevalence of depression ranged from 13 -27%, which is similar to the rate seen in our sample (25%)[12,14]. Depression is prevalent in the elderly and is associated with increased morbidity and mortality, perhaps it is the most frequent cause of emotional sufferings in later life[ 1 5 - 2 1 ]. It is particularly important for primary care physicians to be aware of the symptoms of depression, as it may present with only simple sleep disturbances. It is often under-diagnosed and/or under- recognized by primary care physicians[18,21]. A large number of studies assessing the relationship between depression and medical burden have focused on patients with cardiac diseases, and recent researches have focused on the role of depression as an independent risk factor for cardiac disease[16,17,21]. Of morbidity identified within this population, the one illness that can be relatively easily treated, is depression. This treatment would have a beneficial effect on several domains. It would improve the cognitive function of the individuals as well as increase their motivation to maintain activity and independence. Depression is an illness identified in the elderly that should be diagnosed well and easily treated in order to hasten remission rate, prevent relapse, and improve patient’s quality of life.

SSRI (the newer antidepressants) have been compared with the tricyclic antidepressants and have been found to be more effective, with higher levels of tolerance, fewer dosage adjustments and greater acceptance among the elderly[21]. Presence of age-related functional disability did not influence the self-independence state of the elderly until they were above 85. This was consistent with the fact that aging process, mobility and self-dependence were not influenced by the diseases the patients had[11-13].

As people grow above 85, their independence is lost and they rarely depend on themselves as the majority become immobile[ 1 4 , 2 1 ]. Many factors contributed to the causation of immobility in old age and these included, physical causes such as osteoarthrosis of the joints, neurological deficit, previous falls and sensory deprivation. Social factors such as retirement, loneliness, and many others[3,14,21] also contributed to immobility. High prevalence of age-related disability among the subjects was consistent with the findings that increasing age was associated with increasing disability, and loss of independence due to functional impairments such as loss of mobility, vision, and hearing[ 3 , 2 2 ]. As individuals become older, normal changes occur, slowing down vital processes, thereby resulting in anatomical changes and altered functions. A study done in