Depression, Anxiety, and Stress among Community-Dwelling Older Adults in Rural North India: Burden, Severity and Gender Differences

Abstract

Background:
Population of older adults is rapidly increasing worldwide, and mental health disorders are emerging as a major public health concern. Depression, anxiety, and stress significantly affect quality of life, especially in rural settings with limited healthcare access.

Aims: To assess the socio-demographic profile and determine the prevalence and severity of depression, anxiety, and stress among older adults using DASS-21.

Settings and Design: A community-based cross-sectional study was conducted from January to June 2024 in a Rural District of North India.

Methods and materials: A total of 384 older adults (≥60 years) were selected using multistage random sampling.

Statistical analysis used: Data were collected using a pretested semi-structured questionnaire and the Depression Anxiety Stress Scale (DASS-21). Data were analysed using SPSS version 25. Chi-square test was applied, with p < 0.05 considered statistically significant.

Results: Among 384 participants, 53.4% were males and 46.6% females. In them, 65.9% were married and 60.9% of the participants belonged to the lower socioeconomic class. Prevalence of depression, anxiety, and stress was 25.5%, 34.9%, and 26%, respectively. Higher severity levels were observed among females, with significant gender differences (p < 0.05). This study demonstrated a strong positive correlation between depression, anxiety, and stress scores among the older adults, (Depression vs Anxiety r=0.68 p<0.001), (Depression vs Stress r=0.72, (p<0.001), (Anxiety vs Stress r=0.75, p<0.001) with all associations being statistically significant.

Conclusions:
A substantial proportion of older adults in a rural district of North India suffered from symptoms of depression, anxiety, and stress, with females being disproportionately affected.