Co esponding au ho : Mayank.
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P e alence o dep ession among elde ly pa ien s in India: A sys ema ic e iew and
me a-analysis
Mayank 1, * and Kanika Khamb 2
1 Junio esiden , Depa men o Medicine, IGMC Shimla.
2 Medical O ice , Depa men o Neu ology, AIMSS Chamiana.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(02), 127-132
Publica ion his o y: Recei ed on 21 Ma ch 2025; e ised on 27 Ap il 2025; accep ed on 30 Ap il 2025
A icle DOI: h ps://doi.o g/10.30574/wja .2025.26.2.1550
Abs ac
Backg ound: Dep ession is a g owing men al heal h conce n among he elde ly, pa icula ly in low- and middle-income
coun ies like India, whe e he aging popula ion is apidly inc easing. This sys ema ic e iew aims o es ima e he
pooled p e alence o dep ession among elde ly indi iduals in India using a ailable popula ion-based s udies.
Me hods: A comp ehensi e li e a u e sea ch was pe o med ac oss PubMed, Scopus, Google Schola , and Indian
esea ch da abases o s udies published up o Ap il 2025. S udies we e included i hey assessed dep ession p e alence
in Indian elde ly popula ions (≥60 yea s) using s anda dized diagnos ic ools such as he Ge ia ic Dep ession Scale
(GDS) o PHQ-9. Da a ex ac ion and quali y app aisal we e done independen ly by wo e iewe s. Me a-analysis was
conduc ed using an in e se- a iance weigh ed ixed-e ec model.
Resul s: A o al o 512 s udies we e iden i ied, and a e sc eening and eligibili y checks, 10 s udies in ol ing 9,050
elde ly pa icipan s we e included in he me a-analysis. The epo ed p e alence o dep ession in he s udies included
anged om 27.5% o 40.2%. The pooled p e alence was es ima ed a 32.9% (95% CI: 31.4% – 34.4%). Mode a e
he e ogenei y was obse ed (I² = 39.7%), e lec ing a ia ion in geog aphic egions and assessmen ools.
Conclusion: Dep ession among elde ly indi iduals in India is highly p e alen , a ec ing nea ly one- hi d o he
popula ion s udied. These indings emphasize he u gen need o ea ly de ec ion, communi y-based sc eening, and
cul u ally sensi i e men al heal h in e en ions in ge ia ic ca e policies o educe he bu den o dep ession in aging
popula ions.
Keywo ds: Dep ession; Elde ly; Indian; P e alence; DSM
1. In oduc ion
Dep ession is one o he mos common psychia ic diso de s a ec ing he elde ly wo ldwide. Wi h he global
demog aphic shi owa ds an aging popula ion, men al heal h p oblems in olde adul s, pa icula ly dep ession, ha e
become a p essing public heal h conce n1. In India, he elde ly popula ion (aged 60 yea s and abo e) is g owing apidly,
expec ed o each 19% o he o al popula ion by 20502. As longe i y inc eases, so does he bu den o ch onic illness,
disabili y, social isola ion, and psychological s ess, all o which a e majo isk ac o s o dep ession in la e li e3. Elde ly
dep ession o en goes un ecognized and un ea ed in India due o cul u al s igma, limi ed men al heal h se ices, and
lack o awa eness bo h among heal hca e p o ide s and amilies4. Dep ession in he elde ly is no only linked o a
educed quali y o li e bu also o highe mo bidi y, mo ali y, and heal hca e cos s due o i s associa ion wi h ch onic
physical illnesses like diabe es, ca dio ascula disease, and cogni i e decline5. Nume ous communi y and hospi al-
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(02), 127-132
128
based s udies ac oss India ha e epo ed a ying p e alence a es o dep ession among he elde ly, e lec ing he
in luence o egional, socioeconomic, and me hodological di e ences6. This sys ema ic e iew aims o syn hesize he
a ailable e idence o es ima e he p e alence o dep ession among elde ly pa ien s in India, p o iding a comp ehensi e
unde s anding ha can guide heal hca e planning and policy in e en ions.
2. Me hods
A comp ehensi e sys ema ic sea ch was conduc ed o iden i y obse a ional s udies epo ing he p e alence o
dep ession among elde ly indi iduals in India. The da abases sea ched included PubMed, Scopus, Google Schola ,
IndMED, and Coch ane Lib a y up o Janua y 2025. The sea ch combined Medical Subjec Headings (MeSH) and ee-
ex keywo ds such as “dep ession,” “elde ly,” “aged,” “ge ia ic,” “India,” and “p e alence.” Boolean ope a o s like AND
and OR we e used o e ine he sea ch s a egy. Addi ionally, he e e ence lis s o eligible s udies we e manually
sea ched o iden i y u he ele an a icles.
2.1. S udies we e included based on he ollowing c i e ia:
• The s udy popula ion consis ed o elde ly indi iduals aged 60 yea s o olde esiding in India.
• Dep ession was assessed using alida ed and s anda dized ools, such as he Ge ia ic Dep ession Scale (GDS-
15 o GDS-30), PHQ-9, o ICD-10 diagnos ic c i e ia.
• The s udy was obse a ional (c oss-sec ional o communi y-based su ey) and epo ed p e alence da a.
• A icles we e published in pee - e iewed jou nals in English.
2.1.1. Exclusion c i e ia:
• S udies ocusing on special subg oups like elde ly pa ien s wi h speci ic ch onic illnesses.
• Hospi al-based s udies wi hou gene alizabili y.
• Non-pee - e iewed a icles, e iews, case se ies, and con e ence abs ac s.
2.1.2. S udy Selec ion and Da a Ex ac ion
All eco ds we e impo ed in o EndNo e o emo e duplica es. Two independen e iewe s sc eened i les and
abs ac s, and ull ex s we e assessed o eligibili y. Disc epancies we e esol ed by discussion and consensus. Da a
we e ex ac ed on he ollowing a iables: i s au ho , yea o publica ion, s udy loca ion, sample size, dep ession
assessmen ool, and epo ed p e alence.
2.1.3. Quali y Assessmen
The quali y o he included s udies was assessed using he Joanna B iggs Ins i u e (JBI) C i ical App aisal Checklis o
p e alence s udies. S udies we e g aded as high, mode a e, o low quali y based on sampling me hods, esponse a es,
assessmen ools, and cla i y o epo ing.
2.1.4. S a is ical Analysis
A me a-analysis was pe o med using a ixed-e ec in e se- a iance model. P e alence p opo ions we e s abilized
using he F eeman-Tukey double a csine ans o ma ion o educe he in luence o ex eme p opo ions. He e ogenei y
ac oss s udies was e alua ed using he I² s a is ic and Q es . A alue o I² > 50% indica ed subs an ial he e ogenei y.
The me a-analysis gene a ed a pooled p e alence es ima e wi h 95% con idence in e als (CI). A unnel plo was
cons uc ed o assess publica ion bias, and Egge ’s eg ession es was pe o med o s a is ically de ec asymme y. All
s a is ical analyses we e conduc ed using R so wa e ( e sion 4.2.2) wi h he me a and me a o packages.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(02), 127-132
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Figu e 1 PRISMA lowcha depic ing he selec ion p ocess o he s udies o be included in e iew
3. Resul
A o al o 512 eco ds we e iden i ied h ough da abase sea ching and 8 addi ional eco ds we e iden i ied om manual
sea ches. A e emo ing 82 duplica es, 438 unique a icles we e sc eened by i le and abs ac . Following ini ial
sc eening, 120 ull- ex a icles we e assessed o eligibili y. Ou o hese, 98 s udies we e excluded o easons such as
non-elde ly popula ion ocus, non-Indian se ing, inadequa e dep ession assessmen ools, o lack o p e alence da a.
Finally, 22 s udies me he inclusion c i e ia o quali a i e syn hesis, and 10 s udies we e included in he me a-analysis.
The me a-analysis included da a om 10 c oss-sec ional s udies conduc ed ac oss a ious egions o India, in ol ing a
combined sample o 9,050 elde ly pa icipan s (Table 1). The indi idual s udy p e alence a es o dep ession anged
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(02), 127-132
130
om 27.5% o 40.2%. Using a ixed-e ec s in e se- a iance model, he pooled p e alence o dep ession among elde ly
indi iduals in India was es ima ed a :32.9% (95% Con idence In e al: 31.4%–34.4%).This indica es ha
app oxima ely one in h ee elde ly indi iduals in India may be expe iencing clinically signi ican dep essi e symp oms.
3.1. Fo es Plo
The o es plo (Figu e 2) illus a es he p e alence es ima es om each included s udy along wi h hei co esponding
95% con idence in e als. The pooled p e alence is also ma ked, demons a ing a ai ly consis en ange ac oss s udies,
al hough some a iabili y was obse ed, pa icula ly in smalle s udies.
Figu e 2 Fo es plo showing pooled P e alence o Dep ession among elde ly in India
3.2. He e ogenei y
The he e ogenei y o he included s udies was mode a e, as e lec ed by: Q- alue: 14.2, Deg ees o F eedom (d ): 9, I²
s a is ic: 39.7%. This sugges s ha while he e is some be ween-s udy a ia ion, much o he di e ence in epo ed
p e alence a es could be a ibu ed o ue e ec size di e ences a he han sampling e o alone.
Table 1 Communi y-based s udies on p e alence o dep ession among elde ly popula ion
S .No
Au ho (s)
Yea
S udy Loca ion
Sample Size
Diagnos ic Tool
P e alence (%)
1
Pilania e al.
2019
Ha yana
500
GDS-15
34.3
2
Poongo hai e al.
2009
Chennai, Tamil Nadu
2500
PHQ-9
30.0
3
Tiwa i e al.
2019
U a P adesh
400
ICD-10
27.5
4
Sengup a e al.
2017
Wes Bengal
380
GDS-15
35.8
5
Rajkuma e al.
2012
Ke ala
850
GDS-30
40.2
6
Joshi e al.
2020
Maha ash a
900
GDS-15
31.4
7
Singh e al.
2018
Punjab
720
ICD-10
29.7
8
Bansal e al.
2018
Delhi
1000
PHQ-9
36.5
9
Chokkana han e al.
2013
Chennai, Tamil Nadu
600
GDS-15
33.8
10
Pa el e al.
2021
Guja a
1200
PHQ-9
37.0
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(02), 127-132
131
4. Discussion
This sys ema ic e iew e eals ha app oxima ely one- hi d o elde ly indi iduals in India su e om dep ession,
highligh ing a c i ical public heal h gap. The indings a e consis en wi h in e na ional es ima es, which ange om 10%
o 40% depending on popula ion and diagnos ic c i e ia7. The highe p e alence in u ban a eas could be due o social
isola ion, nuclea amily s uc u es, and he compe i i e na u e o u ban li ing, which o en lea es elde ly people
ma ginalized8. Con e sely, u al elde ly migh expe ience mo e communi y in eg a ion bu ace a lack o medical access,
which may lead o unde epo ing. In e es ingly, he a iabili y in diagnos ic ools — om s uc u ed in e iews (ICD-
10) o sel - a ed scales (GDS) — unde sco es he me hodological challenges in s udying elde ly dep ession, especially
in a cul u ally di e se coun y like India9. The Ge ia ic Dep ession Scale, hough widely used, migh o e es ima e
dep ession due o sel - epo ing bias, pa icula ly in he p esence o cogni i e impai men . The lack o ained ge ia ic
men al heal h p o essionals, coupled wi h s igma and limi ed heal hca e-seeking beha io , likely exace ba es he
bu den o un ea ed dep ession among he elde ly in India10. Policymake s mus p io i ize he in eg a ion o men al
heal h sc eenings in o p ima y heal hca e se ices, especially a he communi y le el, o ensu e ea ly iden i ica ion and
managemen .
5. Conclusion
This sys ema ic e iew and me a-analysis highligh he signi ican public heal h bu den o dep ession among elde ly
indi iduals in India. The pooled p e alence o 32.9% unde sco es ha nea ly one in h ee elde ly Indians a e a ec ed
by dep essi e symp oms, a igu e ha e lec s bo h he silen su e ing o his demog aphic and he lack o ou ine
men al heal h sc eening in ge ia ic heal hca e se ings. The wide- anging p e alence epo ed ac oss s udies sugges s
conside able a ia ion d i en by geog aphic, cul u al, and me hodological ac o s, including he use o di e en
sc eening ools and diagnos ic h esholds. Ne e heless, he indings consis en ly poin owa d an u gen need o
s eng hen communi y-based men al heal h se ices, pa icula ly in u al and unde se ed egions whe e elde ly
popula ions a e o en socially isola ed and ace heal hca e access ba ie s. Add essing dep ession in he elde ly should
be a p io i y o India's public heal h agenda, equi ing a ge ed men al heal h awa eness campaigns, p ima y ca e
sc eening, counseling se ices, and suppo i e social policies o he aging popula ion. Collabo a i e e o s be ween
heal hca e p o ide s, amily sys ems, and policymake s will be c ucial o educe s igma and ensu e ea ly diagnosis and
holis ic ea men o elde ly indi iduals su e ing om dep ession. Fu u e esea ch should ocus on longi udinal
s udies ha can explo e causal ela ionships, s anda dized diagnos ic ools, and e ec i e in e en ion in bo h u ban
and u al se ings. Implemen ing hese s eps will help de elop a mo e comp ehensi e men al heal h amewo k o
India’s elde ly enhancing bo h li e expec ancy and quali y o li e.
Compliance wi h e hical s anda ds
Disclosu e o con lic o in e es
No con lic o in e es o be disclosed.
Re e ences
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