Depression among the elderly is a growing public health concern, often overlooked in clinical practice due to its atypical presentation and overlap with physical ailments and cognitive decline (1). As populations age globally, the burden of mental health conditions such as late-life depression is increasing, affecting up to 20–30% of older adults in various settings (2). Unlike depression in younger populations, depression in the elderly is frequently associated with functional impairment, reduced quality of life, increased healthcare utilization, and a higher risk of mortality, including suicide (3,4).

In primary care settings, depression in older adults often goes undiagnosed, partly because symptoms may be misattributed to aging or chronic physical illnesses (5). Furthermore, older individuals may be less likely to report emotional distress due to stigma, low health literacy, or cultural attitudes toward mental health (6). General practice serves as a critical point of contact for elderly patients and offers a valuable opportunity for early identification and intervention for depressive symptoms (7).

Several risk factors contribute to the development of depression in later life, including chronic medical conditions, bereavement, social isolation, cognitive decline, and reduced physical activity (8,9). Living alone and lack of social support have been consistently linked to poor psychological well-being in older adults (10). Additionally, comorbidities such as diabetes, cardiovascular disease, and arthritis can exacerbate depressive symptoms and complicate treatment efforts (11).

Despite the availability of validated screening tools, such as the Geriatric Depression Scale (GDS), routine mental health screening in primary care remains limited in many regions (12). The use of brief, standardized instruments can facilitate early recognition and management, improving prognosis and quality of life for older patients (13). There is a growing need to integrate mental health assessments into primary care practice, especially in resource-limited settings where specialist services may not be readily accessible.

This study aims to estimate the prevalence of depression and identify associated risk factors among elderly patients attending general practice clinics, using the GDS-15 as a screening tool.

The study included 300 patients aged 60 years and above who visited the participating clinics during the study period. Inclusion criteria were the ability to communicate, provide informed consent, and complete the interview process. Patients with severe cognitive impairment, active psychosis, or terminal illness were excluded to ensure reliability of responses.

Sampling Method

A systematic random sampling technique was employed, selecting every third eligible patient on clinic rosters during each working day until the target sample size was reached.

Data Collection

Data were collected through face-to-face interviews using a structured questionnaire. The tool included sections on sociodemographic information, medical history, lifestyle habits (physical activity, smoking, alcohol use), living arrangements, and perceived social support. Cognitive status was assessed using the Mini-Cog test.

Depression Screening

Depression was screened using the 15-item Geriatric Depression Scale (GDS-15), a validated and widely used instrument for assessing depressive symptoms in older adults. A GDS-15 score of 5 or more was considered indicative of depression. The screening was conducted in a private setting to maintain confidentiality and encourage honest responses.

Statistical Analysis

Data were analyzed using SPSS version 26. Descriptive statistics (means, standard deviations, frequencies, and percentages) were used to summarize participant characteristics. Chi-square tests were employed to assess associations between depression and categorical variables, while logistic regression analysis was used to identify independent predictors. A p-value of less than 0.05 was considered statistically significant.

A total of 300 elderly patients participated in the study, with a mean age of 68.4 ± 5.9 years. The majority were females (55.3%), and 63.7% of participants were married. Nearly half of the respondents (49%) had at least one chronic illness, and 34% reported living alone. Cognitive impairment was identified in 28.7% of the participants using the Mini-Cog screening tool.

Out of the total sample, 92 individuals (30.7%) screened positive for depression based on GDS-15 scores ≥5. The baseline demographic and clinical features are detailed in Table 1.

Table 1: Sociodemographic and Clinical Profile of Participants (n = 300)

Depression was significantly more prevalent among participants who lived alone (45.1%), had chronic medical conditions (39.5%), engaged in low physical activity (37.8%), or had cognitive impairment (42.6%). No significant association was found between depression and gender, marital status, or educational background (Table 2).

Table 2: Association Between Risk Factors and Depression (n = 300)

*Statistically significant (p < 0.05)

Multivariate logistic regression analysis confirmed that living alone (OR = 2.1, 95% CI: 1.2–3.7), chronic illness (OR = 2.6, 95% CI: 1.5–4.5), low physical activity (OR = 1.9, 95% CI: 1.1–3.3), and cognitive impairment (OR = 2.3, 95% CI: 1.3–4.0) were independently associated with higher odds of depression in elderly patients.

The present study reveals that approximately one-third (30.7%) of elderly patients attending general practice clinics screened positive for depression using the Geriatric Depression Scale (GDS-15). This prevalence aligns with findings from prior research in similar primary care settings, where rates have ranged between 25% and 35% depending on geographical, cultural, and methodological factors (1,2). Depression in the elderly often remains underdiagnosed due to its nonspecific symptoms and overlap with somatic illnesses (3).

Living alone was significantly associated with depression in our sample. Social isolation and the absence of emotional support are known contributors to psychological distress in the elderly (4,5). Studies have consistently shown that elderly individuals living alone have a two- to three-fold higher risk of depression compared to those cohabiting with family (6,7). In India, this trend is growing due to the nuclear family structure and urban migration of younger family members (8).

Chronic illnesses such as diabetes, hypertension, and osteoarthritis were prevalent among the participants and were independently associated with depressive symptoms. This is consistent with international data showing that multimorbidity is both a physical and psychological burden for elderly patients (9,10). The bidirectional relationship between depression and chronic illness complicates disease management and lowers quality of life (11).

Cognitive impairment was also significantly associated with depression in this study. Prior work has demonstrated that early stages of cognitive decline may result in heightened awareness of functional limitations, contributing to emotional distress (12). Moreover, depression itself is a known risk factor for accelerated cognitive decline in aging populations (13).

Low physical activity emerged as another significant predictor of depression. Physical inactivity leads to reduced endorphin release and fewer social interactions, both of which are important in regulating mood (14). Physical activity programs tailored for the elderly have been shown to reduce depressive symptoms and improve overall well-being (15).

Depression is highly prevalent among elderly patients in general practice, with significant associations found with social isolation, chronic illness, and cognitive decline. Routine screening and integrated management approaches are essential to improve mental health outcomes in this vulnerable population.

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