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Impact of illiteracy on depression symptomatology in community-dwelling older adults

Published online by Cambridge University Press:  19 June 2014

Byung-Soo Kim
Affiliation:
Department of Psychiatry, Kyungpook National University School of Medicine, Daegu, South Korea
Dong-Woo Lee
Affiliation:
Department of Psychiatry, Inje University College of Medicine, Seoul, South Korea
Jae Nam Bae
Affiliation:
Department of Psychiatry, Inha University College of Medicine, Incheon, South Korea
Sung Man Chang
Affiliation:
Department of Psychiatry, Kyungpook National University School of Medicine, Daegu, South Korea
Shinkyum Kim
Affiliation:
Department of Psychiatry, Yangsan Mental Hospital, Yangsan, South Korea
Ki Woong Kim
Affiliation:
Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, South Korea
Hyo-Deog Rim
Affiliation:
Department of Psychiatry, Kyungpook National University School of Medicine, Daegu, South Korea
Jee Eun Park
Affiliation:
Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
Maeng Je Cho*
Affiliation:
Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, South Korea Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
*
Correspondence should be addressed to: Dr Maeng Je Cho, MD, PhD, Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 28 Yeongeon-dong, Jongno-gu, Seoul 110-744, South Korea. Phone: +82-2-2072-3155; Fax: +82-2-744-7241. Email: mjcho@snu.ac.kr.

Abstract

Background:

In many countries, illiteracy rates among aged people are quite high. However, only few studies have specifically investigated the impact of illiteracy on depression.

Methods:

Data for 1,890 elderly individuals (aged ≥65 years) were obtained from a nationwide dementia epidemiological study conducted in South Korea. Based on their reading ability, the participants were divided into three groups: totally illiterate, partially illiterate, and literate. The Korean version of the Geriatric Depression Scale – Short Form (SGDS-K) was used to detect depression (cut-off score = 8). Multivariate logistic regression analyses were used to assess the association between illiteracy and depression. To explore clinical features of depression in illiterate people, we performed logistic regression to calculate odds ratios of positive responses (or negative responses to reverse-coded items) for each SGDS-K item using literate individuals as the reference group.

Results:

Totally illiterate participants had 2.41 times the odds and partially illiterate individuals had 1.59 times the odds of being depressed compared with literate participants after controlling for other variables. Compared with literate individuals, illiterate elderly persons were at increased odds for responding negatively to the majority of SGDS-K items, including “having memory problems,” “others are better off than me,” and “feeling worthless” even after controlling for various demographic and clinical factors.

Conclusions:

Illiteracy in elderly individuals was associated with a higher rate and increased severity of depression. Illiteracy negatively affected depression symptomatology, especially factors associated with self-esteem. Therefore, clinicians should carefully monitor for the presence of depression in illiterate elderly adults.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2014 

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References

Almeida, O. P. et al. (2012). Socioeconomic disadvantage increases risk of prevalent and persistent depression in later life. Journal of Affective Disorders, 138, 322331.CrossRefGoogle ScholarPubMed
Andrews, B., Qian, M. and Valentine, J. D. (2002). Predicting depressive symptoms with a new measure of shame: The Experience of Shame Scale. British Journal of Clinical Psychology, 41, 2942.Google Scholar
Aranda, M. P., Chae, D. H., Lincoln, K. D., Taylor, R. J., Woodward, A. T. and Chatters, L. M. (2012). Demographic correlates of DSM-IV major depressive disorder among older African-Americans, Black Caribbeans, and non-Hispanic Whites: results from the National Survey of American Life. International Journal of Geriatric Psychiatry, 27, 940947.Google Scholar
Azar, A. R., Murrell, S. A. and Mast, B. T. (2005). Race and vascular depression risk in community-dwelling older adults. American Journal of Geriatric Psychiatry, 13, 329332.CrossRefGoogle ScholarPubMed
Back, J. H. and Lee, Y. (2011). Gender differences in the association between socioeconomic status (SES) and depressive symptoms in older adults. Archives of Gerontology and Geriatrics, 52, 140144.Google Scholar
Bae, J. N. and Cho, M. J. (2004). Development of the Korean version of the Geriatric Depression Scale and its short form among elderly psychiatric patients. Journal of Psychosomatic Research, 57, 297305.Google Scholar
Baker, D. W. et al. (1996). The health care experience of patients with low literacy. Archives of Family Medicine, 5, 329334.Google Scholar
Baker, D. W. et al. (2002). Functional health literacy and the risk of hospital admission among Medicare managed care enrollees. American Journal of Public Health, 92, 12781283.Google Scholar
Beck, A. T. (2002). Cognitive models of depression. In Leahy, R. L. and Dowd, E. T. (eds.), Clinical Advances in Cognitive Psychotherapy: Theory and Application (pp. 2961). New York, NY: Springer.Google Scholar
Beekman, A. T., Copeland, J. R. and Prince, M. J. (1999). Review of community prevalence of depression in later life. British Journal of Psychiatry, 174, 307311.Google Scholar
Beekman, A. T., Deeg, D. J., Geerlings, S. W., Schoevers, R. A., Smit, J. H. and van Tilburg, W. (2001). Emergence and persistence of late life depression: a 3-year follow-up of the Longitudinal Aging Study, Amsterdam. Journal of Affective Disorders, 65, 131138.Google Scholar
Beekman, A. T., Deeg, D. J., Smit, J. H. and van Tilburg, W. (1995). Predicting the course of depression in the older population: results from a community-based study in the Netherlands. Journal of Affective Disorders, 34, 4149.Google Scholar
Bender, D. E. and McCann, M. F. (1993). Validation of self-report of literacy among periurban women in Bolivia. International Journal of Epidemiology, 22, 747748.Google Scholar
Berkman, L. F. et al. (1986). Depressive symptoms in relation to physical health and functioning in the elderly. American Journal of Epidemiology, 124, 372388.Google Scholar
Blazer, D. and Williams, C. D. (1980). Epidemiology of dysphoria and depression in an elderly population. American Journal of Psychiatry, 137, 439444.Google Scholar
Carvalho, S., Dinis, A., Pinto-Gouveia, J. and Estanqueiro, C. (2013). Memories of shame experiences with others and depression symptoms: the mediating role of experiential avoidance. Clinical Psychology & Psychotherapy. doi: 10.1002/cpp.1862.Google Scholar
Chi, I. et al. (2005). Prevalence of depression and its correlates in Hong Kong's Chinese older adults. American Journal of Geriatric Psychiatry, 13, 409416.Google Scholar
Cho, M. J., Lee, J. Y., Kim, B. S., Lee, H. W. and Sohn, J. H. (2011). Prevalence of the major mental disorders among the Korean elderly. Journal of Korean Medical Science, 26, 110.Google Scholar
De Ronchi, D., Fratiglioni, L., Rucci, P., Paternico, A., Graziani, S. and Dalmonte, E. (1998). The effect of education on dementia occurrence in an Italian population with middle to high socioeconomic status. Neurology, 50, 12311238.CrossRefGoogle Scholar
DeWalt, D. A. and Pignone, M. P. (2005). Reading is fundamental: the relationship between literacy and health. Archives of Internal Medicine, 165, 19431944.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-Mental State.” A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.Google Scholar
Gan, Z. et al. (2012). The impact of educational status on the clinical features of major depressive disorder among Chinese women. Journal of Affective Disorders, 136, 988992.Google Scholar
Gazmararian, J., Baker, D., Parker, R. and Blazer, D. G. (2000). A multivariate analysis of factors associated with depression: evaluating the role of health literacy as a potential contributor. Archives of Internal Medicine, 160, 33073314.Google Scholar
Kamiya, Y., Doyle, M., Henretta, J. C. and Timonen, V. (2013). Depressive symptoms among older adults: the impact of early and later-life circumstances and marital status. Aging & Mental Health, 17, 349357.Google Scholar
Karp, A., Kareholt, I., Qiu, C., Bellander, T., Winblad, B. and Fratiglioni, L. (2004). Relation of education and occupation-based socioeconomic status to incident Alzheimer's disease. American Journal of Epidemiology, 159, 175183.Google Scholar
Kehoe, R., Wu, S. Y., Leske, M. C. and Chylack, L. T. Jr. (1994). Comparing self-reported and physician-reported medical history. American Journal of Epidemiology, 139, 813818.Google Scholar
Kim, K. W. et al. (2011). A nationwide survey on the prevalence of dementia and mild cognitive impairment in South Korea. Journal of Alzheimer's Disease, 23, 281291.Google Scholar
Lee, J. H. et al. (2002). Development of the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K): clinical and neuropsychological assessment batteries. Journals of Gerontology, Series B, 57, 4753.Google Scholar
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939944.Google Scholar
Murrell, S. A., Himmelfarb, S. and Wright, K. (1983). Prevalence of depression and its correlates in older adults. American Journal of Epidemiology, 117, 173185.Google Scholar
OECD. (2013). OECD Factbook 2013. Paris Cedex, France: OECD.Google Scholar
Okura, Y., Urban, L. H., Mahoney, D. W., Jacobsen, S. J. and Rodeheffer, R. J. (2004). Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure. Journal of Clinical Epidemiology, 57, 10961103.Google Scholar
Parikh, N. S., Parker, R. M., Nurss, J. R., Baker, D. W. and Williams, M. V. (1996). Shame and health literacy: the unspoken connection. Patient Education and Counseling, 27, 3339.Google Scholar
Qiu, C., Backman, L., Winblad, B., Aguero-Torres, H. and Fratiglioni, L. (2001). The influence of education on clinically diagnosed dementia incidence and mortality data from the Kungsholmen Project. Archives of Neurology, 58, 20342039.Google Scholar
Schoevers, R. A., Beekman, A. T., Deeg, D. J., Geerlings, M. I., Jonker, C. and Van Tilburg, W. (2000). Risk factors for depression in later life; results of a prospective community based study (AMSTEL). Journal of Affective Disorders, 59, 127137.Google Scholar
Sheikh, V. I. and Yesavage, V. A. (1986). Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. In Brink, T. L. (ed.), Clinical Gerontology – A Guide to Assessment and Intervention (pp. 165174). New York, NY: Haworth Press.Google Scholar
Stuewig, J. and McCloskey, L. A. (2005). The relation of child maltreatment to shame and guilt among adolescents: psychological routes to depression and delinquency. Child Maltreatment, 10, 324336.Google Scholar
The National Institute of the Korean language (2008). Basic Literacy Survey of Korean People. Seoul, South Korea: The National Institute of Korean Language.Google Scholar
UNESCO Institute for Statistics (2013). Adult and Youth Literacy: National, Regional and Global Trends, 1985–2015. Montreal, Canada: UNESCO Institute for Statistics.Google Scholar
Unutzer, J. et al. (1997). Depressive symptoms and the cost of health services in HMO patients aged 65 years and older. A 4-year prospective study. JAMA, 277, 16181623.Google Scholar
Weiss, B. D., Francis, L., Senf, J. H., Heist, K. and Hargraves, R. (2006). Literacy education as treatment for depression in patients with limited literacy and depression: a randomized controlled trial. Journal of General Internal Medicine, 21, 823828.Google Scholar
Weiss, B. D., Sheehan, C. P. and Gushwa, L. L. (2009). Is low literacy a risk factor for symptoms of depression in postpartum women? Journal of Reproductive Medicine, 54, 563568.Google ScholarPubMed
Williams, M. V. et al. (1995). Inadequate functional health literacy among patients at two public hospitals. JAMA, 274, 16771682.Google Scholar
Wolf, M. S., Gazmararian, J. A. and Baker, D. W. (2005). Health literacy and functional health status among older adults. Archives of Internal Medicine, 165, 19461952.Google Scholar
Wolf, M. S., Williams, M. V., Parker, R. M., Parikh, N. S., Nowlan, A. W. and Baker, D. W. (2007). Patients’ shame and attitudes toward discussing the results of literacy screening. Journal of Health Communication, 12, 721732.Google Scholar