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Mental Health Status of Elderly: A community study in 3 underprivileged neighborhoods in Beirut

Mental Health Status of Elderly: A community study in 3 underprivileged neighborhoods in Beirut. Chaaya M. Sibai A. El-Roueiheb Z. Fayad R. Chemailtelly H. Rationale. Demographic and epidemiologic transitions in Lebanon Circumstances surrounding retirement policies.

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Mental Health Status of Elderly: A community study in 3 underprivileged neighborhoods in Beirut

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  1. Mental Health Status of Elderly:A community study in 3 underprivileged neighborhoods in Beirut Chaaya M. Sibai A. El-Roueiheb Z. Fayad R. Chemailtelly H.

  2. Rationale • Demographic and epidemiologic transitions in Lebanon • Circumstances surrounding retirement policies

  3. Unique Circumstances Surrounding Retirement in Lebanon • Weak fragmented public policies for the retired elderly • Human resources • Few geriatricians • Allied health professionals: none • Limited research

  4. Objectives • Describe the interplay between resources and late life health transitions • Economic position and social networks • Physical functioning and mental health

  5. DATA SOURCE: Urban Health Study (2002-2003) • A new research initiative on the social context of health • A different approach • Engage the ‘communities’ in the research process • data collection & dissemination • ‘Subjects’ are partners – understanding & change • Science & action – intervention for change • Staged implementation (3 phases) • Inter (multi)-disciplinary team of researchers (12+) • Quantitative & qualitative tools

  6. Aims • …to provide policy-relevant data and analysis of the health consequences of economic impoverishment, social support/capital, and population change, particularly displacement • …to identify the social mechanisms impacting health and well being – for intervention • Health problems/risky behaviors • Utilization of health services

  7. Sample &communities • a survey of some 3,000 households (and individuals) • … in three ‘impoverished’ & rapidly changing communities: • Nabaa ~77% Lebanese Christians • Hay el-sollom (part) ~96% Lebanese Muslims • Bourj Barajneh camp ~91% Palestinian Muslims • Selected with …. characteristics: • War displaced populations -Rural origin (city-side migration) • Poverty and other hardships -Lack basic infrastructure • -Social heterogeneity

  8. Four questionnaires: Five main themes A survey (CRPH) & qualitative studies Phase I 2002 Household/ Women & work Individual roster Phase II 2003 NM Adolescents EM women Elders (13-19) (15-59) (60+)

  9. The Elderly Health component: Objectives • To investigate the effect of working status on elderly mental health controlling for other covariates. • To provide demographic, social and health-related information that would become the basis of future follow-up studies

  10. Mental Health Measures (1) • The 15-item Geriatric Depression Scale (GDS) was used to measure depression.  Absence of depression (score less than 5), probable depression (a score of 5 to 10), definite depression (a score of more than 10)on GDS • The 12-item General Health Questionnaire (GHQ) was used to measure distress.  Presence of distress (score of >2) on GHQ

  11. Mental Health Measures (2) • First questionnaire draft included an Arabic parallel version of the Mini-Mental Status Examination (MMSE) questionnaire. • Only 5 cognitive functioning questions (about respondent’s age, relation to household head, area, floor number, number of household members) were included in the final questionnaire because: • The goal was to conduct the interview and not to establish dementia. • High illiteracy rate and thus incompetence of the sampled elderly. • Elderly responses to the 5 cognitive questions were checked against the same data gathered from the household questionnaire to check for truthfulness.

  12. MMSE questions used in the present study

  13. RESULTS

  14. * P value < 0.05

  15. * Distress did not vary significantly across the 3 communities

  16. * P value < 0.05

  17. Table 1: Distribution of respondents by depression status and socio-economic characteristics.

  18. Table 2: Distribution of respondents by depression status and physical health and social capital characteristics.

  19. * Controlling for sex, literacy, marital status, household income, availability of someone to care for elderly when sick, and availability Of help for personal problems.

  20. Discussion (1) • A high elderly depression prevalence was found. • This can be due to an instrument bias OR, • The results can be true. In both cases ….

  21. Discussion (1) • The Arabic version of the GDS should be validated. To our knowledge, this has not yet been done. • Interventions targeting elderly mental health and well-being should be put in place.

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