Skip to main content
PMC home page
Journal of Aging Research logoLink to Journal of Aging Research
. 2021 Aug 16;2021:9305624. doi: 10.1155/2021/9305624

Depression in the Iranian Elderly: A Systematic Review and Meta-Analysis

Hedayat Jafari 1, Dariush Ghasemi-Semeskandeh 2,3,4, Amir Hossein Goudarzian 5, Tahereh Heidari 5, Azar Jafari-Koulaee 5,✉
PMCID: PMC8382523  PMID: 34434582

Abstract

Depression can lead to increased medical costs, impaired individual and social functioning, nonadherence to therapeutic proceeding, and even suicide and ultimately affect quality of life. It is important to know the extent of its prevalence for successful planning in this regard. This study was conducted to determine the prevalence of depression in the Iranian elderly. This systematic review and meta-analysis study was done through Medline via PubMed, SCOPUS, Web of Science, ProQuest, SID, Embase, and Magiran with determined keywords. Screening was done on the basis of relevance to the purpose of the study, titles, abstracts, full text, and inclusion and exclusion criteria. The quality of the articles was assessed using the Newcastle-Ottawa standard scale. After primary and secondary screening, 30 articles were finally included in the study. According to the 30 articles reviewed, the prevalence of depression in the Iranian elderly was 52 percent based on the random-effects model (CI 95%: 46–58). According to the results of the present study, depression in the Iranian elderly was moderate to high. Therefore, more exact assessment in terms of depression screening in elderly people seems necessary. Coherent and systematic programs, including psychosocial empowerment counselling for the elderly and workshops for their families, are also needed. Researchers can also use the results of this study for future research.

1. Introduction

The phenomenon of aging as one of the most sensitive periods of human life is one of the most important economic, social, and health challenges in the world that is expanding with the growing trend [1, 2]. Statistics show that the world population over 60 will double between 2000 and 2050, reaching from 11 to 22 percent [3, 4]. The age pyramid of the Iranian population is also moving from youth to old age, so that the number of elderly people in 1414 reached more than 10 million and the percentage of aging reached more than 11% [5]. The aging process and its associated changes may make the elderly more vulnerable to potential threats such as chronic illnesses [6, 7], loneliness and isolation [8], anxiety, and depression [9]. Mental health disorders have also been reported as the most common disorders in the elderly, with depression being the most prevalent [10, 11]. It was reported that approximately 5 million older adults worldwide experience late-onset depression [12]. According to the World Health Organization, depression is characterized by persistent sadness and lack of interest or enjoyment previously or in pleasurable activities [13]. Unfortunately, depression is less common in the elderly. Aging depression is a condition that does not occur naturally due to aging, and the general symptoms that are a prominent symptom of depression may not be seen. Most of the depressed elderly have fewer complaints of feelings of sadness and grief caused by a depressed mood. Mental preoccupation with health status and extreme and obsessive attention to physical symptoms are other characteristics of depression in the elderly. Another common symptom of depression in the elderly is a complaint of cognitive symptoms such as forgetfulness and distraction, so that the term false dementia is used to describe this clinical picture [14–16]. Factors such as loneliness, decreased ability to work, impaired social support, having one or more physical ailments, and multiple therapeutic interventions can be risk factors for depression in the elderly [17]. Depression in the elderly can lead to increased medical costs, impaired individual, occupational and social functioning, nonadherence to therapeutic proceeding, and even suicide and ultimately affect one's quality of life [18, 19]. Depression is also one of the most important predictors of treatment outcome and survival in these patients [20]. Therefore, it is important to pay attention to the challenges and psychological needs of the elderly as well as identify and evaluate the prevalence of depression in order to prevent depression and its unpleasant side effects and to achieve successful aging and optimal quality of life. A review of the literature revealed that there have been several descriptive studies on the prevalence of depression in the Iranian elderly [21, 22], and so far, only one review study has been conducted in Iran that has reviewed articles on depression in the Iranian elderly by 2015 [23]. Given the time elapsed from this study, it is necessary to conduct more comprehensive study with more accurate and generalizable methods for continuous evaluation. Therefore, the present study was conducted to determine depression in the Iranian elderly in a systematic review and meta-analysis.

2. Materials and Methods

This systematic review and meta-analysis was performed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) with the aim of determining depression in the Iranian elderly in 2020.

2.1. Search Strategy

We searched Medline via PubMed, SCOPUS, Web of Science, ProQuest, SID, EMBASE, and Magiran, from the earliest date possible until the end of 2019. Databases were searched by using keywords including “Depression” OR “Depressive Disorders,” “Iran,” “Prevalence,” and “Elderly OR Aged OR Older adult.” Boolean operators (AND and OR) were used. After searching the database, a list of articles was prepared by two researchers independently and the duplicate articles were removed. The studies were screened based on the titles, abstracts, and full text of the articles. Finally, eligible articles were included in the study process based on inclusion and exclusion criteria.

2.2. Inclusion and Exclusion Criteria

The inclusion criteria were the following: (1) observational studies with keywords listed in the title or abstract of the articles; (2) published in Persian or English; (3) studies with samples of Iranian nationality residing in Iran. Exclusion criteria included the following: (1) low-quality studies based on scale; (2) no relation with the subject and inadequate data such as failure to report the percentage of depression. Also, books and studies without full text and studies in format of abstracts of conference papers were excluded.

2.3. Quality Assessment of Studies

The quality of the selected articles was assessed based on the Newcastle-Ottawa scale. This scale measures the research design, response rate, sample representation, objectivity/reliability of the result, computation power provided, and appropriate statistical analysis. Finally, articles with a score of at least 7 were included in the study. The quality of studies was evaluated independently by two researchers, and the third researcher was used in case of disagreement.

2.4. Data Extraction

Data were extracted using a checklist consisting of first author's name, year of publication, type of study, place of study, sample size, mean age of participants, and percentage of depression. The necessary information was extracted from related articles by two independent researchers.

2.5. Statistical Analysis

The studies reporting the prevalence of depression in the Iranian elderly samples were synthesized using both fixed-effects and random-effects models. The method to be used for pooling of studies was inverse variance. Statistical heterogeneity among reviewed studies was also assessed with I2 statistic. Potential publication bias was visually evaluated with a funnel plot and statistically tested by Egger's test statistic which is based on a weighted linear regression of the treatment effect on its standard error [24]. Statistical analyses were implemented on R version 4.1.0 [25] via metafor package [26].

3. Results

After primary and secondary screening, 30 studies were finally included in the systematic review and meta-analysis. Details of screening steps are presented in Figure 1.

Figure 1.

Figure 1

Open in a new tab

Process of study selection (PRISMA).

3.1. Description of Studies

Thirty articles included in this study were all observational studies and had a good locative distribution throughout Iran. GDS, BDI, Beck, DASS-21, Kessler, HADS, and Elderly Health Master Plan tools were used to assess depression in the elderly. The age range of the participants ranged from 64.22 to 76.97. Other details are presented in Table 1.

Table 1.

Characteristics of the included studies (N = 30).

Author (year) (reference) Study type Place of study Instrument Sample, n (%) Average of age, mean (SD) Prevalence of depression, n (%) Quality of study
Gharangic (2010) [27] Cross-sectional Bandar torkaman GDS-15 Male: 155 (51.7)
Female: 145 (48.3)		 68 (6.7) Normal: 201 (67)
Mild: 60 (20)
Moderate: 30 (10)
Severe: 9 (3)
Total depressed: 33%		 7
Manzoori (2007) [28] Cross-sectional Isfahan GDS-15 Male: 125 (50.4)
Female: 123 (49.6)		 Not reported Normal: 90 (36.3)
Moderate: 101 (40.7)
Severe: 57 (23)
Total depressed: 63.7%		 7
Mobasheri (2008) [29] Descriptive-analytical Shahrekord BDI-21 57 68.7 (16.1) Normal: 9 (15.8)
Mild: 36 (64.9)
Moderate: 9 (15.8)
Severe: 2 (3.5)
Total depressed: 84.2%		 7
Ashrafi (2017) [30] Cross-sectional Salmas GDS-15 Male: 137 (45)
Female: 163 (55)		 68.74 (6.32) Normal: 166 (55.3)
Mild: 84 (28)
Moderate: 31 (10.33)
Severe: 19 (6.3)
Total depressed: 44.7%		 7
Payahoo (2012) [31] Descriptive-analytical Tabriz GDS Male: 97 (52.7) Female: 87 (47.3) 69.4 (7.9) Normal: 106 (57.6)
Moderate: 52 (28.3)
Severe: 26 (14.1)
Total depressed: 42.4%		 7
Alahyari (2014) [32] Descriptive-analytical Tehran Beck 100 Not reported Total depressed: 12% 7
Ghafari (2009) [22] Descriptive-analytical Tehran DASS-21 Male: 25 (24)
Female: 79 (76)		 64.22 (4.57) Normal: 45 (43.2)
Mild: 16 (15.4)
Moderate: 30 (28.9)
Severe: 8 (7.7)
Very severe: 5 (4.8)
Total depressed: 56.8%		 7
Nejati (2006) [33] Cross-sectional, comparative Tehran GDS 120 Not reported Total depressed: 79.8% 7
Alipour et al. (2009) [12] Comparative-analytical Tehran HADS Male: 70 (70)
Female: 30 (30)		 76.97 Total depressed: 40% 7
Rajabizadeh (2002) [34] Cross-sectional Kerman Beck 1212 Not reported Normal: 259 (21.4)
Borderline: 225 (18.6)
Depressed: 728 (60)
Total depressed: 60%		 7
Kashfi (2011) [35] Cross sectional Shiraz Beck Male: 20 (16.7)
Female: 100 (83.3)		 70 Mild: 78 (65)
Moderate: 31 (25.8)
Severe: 11 (9.2)
Total depressed: 100%		 7
Ghaderi (2010) [36] Descriptive, cross-sectional Bookan GDS 302 70.69 Total depressed: 23.3% 7
Saeedi (2009) [37] Cross-sectional Ahvaz GDS Male: 66 (33)
Female: 134 (67)		 71 (8) Total depressed: 9% 8
Alizadeh (2012) [21] Descriptive-analytical Tehran Kessler 402 Not reported Normal: 189 (47.1)
Moderate: 187 (46.5)		 7
Sharifzadeh (2007) [38] Descriptive-analytical Birjand Elderly health master plan 250 71 (7.8) Normal: 71 (28.4)
Mild: 171 (68.4)
Severe: 8 (3.2)
Total depressed: 71.6%		 7
Bakhtiari (2018) [18] Cross-sectional Amirkola GDS Male: 861 (55)
Female: 699 (45)		 69.3 (7.4) Normal: 895 (57.4)
Mild: 420 (26.9)
Moderate: 169 (10.8)
Severe: 76 (4.9)
Total depressed: 42.6%		 7
Mirzaei (2015) [15] Prospective Yazd DASS 9965 Not reported Normal: 473 (47.9)
Mild: 420 (26.9)
Moderate: 169 (10.8)
Severe: 76 (4.9)
Total depressed: 52.1%		 7
Taheri tanjanai (2016) [39] Cross-sectional Tehran GDS-15 Male: 642 (47.5)
Female: 708 (52.5)		 69 (7) Total depressed: 36.7% 8
Keshavarzi (2015) [11] Cross-sectional Shiraz GDS Male: 125 (27.9)
Female: 322 (72.1)		 65.99 (7.89) Total depressed: 38.1% 7
Ahangar (2017) [40] Cross-sectional Amirkola GDS-15 Male: 763 (54.9)
Female: 627 (45.1)		 68.87 (7.23) Total depressed: 43.5% 7
Babazadeh (2016) [41] Cross-sectional Khoy DASS-21 Male: 178 (45.4)
Female: 209 (54.6)		 68.22 Mild: 167 (43.6)
Moderate: 71 (18.5)
Severe: 134 (35.0)
Very severe: 6 (1.6)
Total depressed: 98.7%		 7
Sadeghi (2017) [42] Cross-sectional analytical Shahrood GDS-15 Male: 146 (46)
Female: 169 (54)		 Not reported Mild: 96 (30.4)
Severe: 45 (14.3)
Total depressed: 44.7%		 7
Khalili (2016) [43] Descriptive, cross-sectional Kashan GDS-15 Male: 290 (58)
Female: 210 (42)		 72.07 (9.03) Normal: 112 (22.4)
Mild: 239 (47.8)
Moderate: 120 (24)
Severe: 29 (5.8)
Total depressed: 77.6%		 7
Emami (2017) [44] Cross-sectional Tehran BDI-13 Male: 227 (32.48)
Female: 348 (60.52)		 69.66 (7.91) Normal: 271 (48.13)
Mild: 98 (17.41)
Moderate: 144 (25.58)
Severe: 50 (8.88)
Total depressed: 51.87%		 8
Nazemi (2013) [45] Descriptive-analytical Tehran GDS-15 Male: 130 (53.3)
Female: 114 (46.7)		 75.8 (8.7) Normal: 24 (9.8)
Mild: (50)
Moderate: (29.5)
Severe: (10.7)
Total depressed: 90.2%		 8
Mokhber (2011) [46] Analytical Razavi khorasan GDS Male: 720 (46)
Female: 845 (54)		 70.14 (7.57) Nondepressed: 1165 (78)
Depressed: 330 (22)		 7
Hosseini (2018) [47] Cross-sectional Babol GDS-15 Male: 864 (54.4)
Female: 725 (45.6)		 69.38 (7.44) Normal: 895 (56)
Mild: 436 (27)
Moderate: 176 (11)
Severe: 82 (5)
Total depressed: 43.67%		 7
Majdi (2011) [48] A population-based study Razavi khorasan GDS Male: 917 (46.4)
Female: 1045 (52.9)		 71.14 (7.78) Nondepressed: 1435 (72.2)
Depressed: 440 (22.3)		 7
Dehkordi (2014) [49] Descriptive-analytical Shahrekord GDS-15 52 72.9 (6.5) Normal: 14 (34.2)
Mild: 16 (39.1)
Moderate: 7 (17)
Severe: 4 (9.7)
Total depressed: 65.8%		 7
Karami (2014) [50] Descriptive-analytical Kermanshah Beck Male: 223 (58.2)
Female: 160 (41.8)		 70.11 (5.7) Normal: (32.4)
Mild: (18.5)
Moderate: (40.2)
Severe: (5.7)
Very severe: (3.1)
Total depressed: 67.6%		 7
Open in a new tab

3.2. Meta-Analysis Results

The range of sample size from the included articles varied from 52 to 9965, with a mean and median of 863 and 315, respectively. Based on the 30 identified articles, the reported prevalence of depression ranged from 9 to 100 percent, with the average of 52.15 percent.

It can be found in Figure 2 that the synthesized prevalence of depression among the elderly people in Iran for the random-effects model was 52% (95% CI: 46–58). The Q-test for pooled estimates was statistically significant at the level of 0.001 (Q = 1890.68, df = 29, p < 0.001, I2 = 98%) representing noticeable between-study heterogeneity.

Figure 2.

Figure 2

Open in a new tab

Forest plot of the selected studies.

The publication bias was also evaluated by visualizing the funnel plot for analysis. The funnel plot (Figure 3) depicts how heterogeneous the effect sizes of the elected studies are. The p value associated with Egger's test is 0.748, indicating symmetry of the funnel plot.

Figure 3.

Figure 3

Open in a new tab

Funnel plot of the selected studies.

4. Discussion

According to the results of this study, the prevalence of depression in the Iranian elderly was 52%. In a similar study, the prevalence of depression in the Iranian elderly was 43 percent, according to a review of studies conducted between 2001 and 2015 [23]. Comparison of the results of the present study and the mentioned study [23] indicates that the prevalence of depression in the Iranian elderly has increased over time. Also, another study with a review of 83 studies in this field reported that 27 percent of the elderly suffer from depression [51], with the prevalence of depression in this study being less than the prevalence of depression in the Iranian elderly. Possible reasons for the difference in the prevalence of depression in these studies may be the structures intended by governments and the culture of societies in relation to elderly people and their needs. In some countries, especially developed countries, there is a more favourable formalized mental healthcare system for the elderly, which can affect the prevention and promotion of their mental health, especially depression screening. Also, increasing rates of disease and medicine consumption in developing countries such as Iran may increase the experience of depression in the elderly.

In the present study, the lowest prevalence of depression was in the study by Saeedi et al. [37] and the highest was in the study by Kashafi et al. [35]. Possible reasons for the differences in results may be the differences in the place of study and the different cultural contexts and tools used. Saeedi et al.'s study [37] was conducted in Ahvaz, and another study was conducted in Shiraz. In the study of Saeedi et al. [37], the Geriatric Depression Scale (GDS) was used and, in the latter, the Beck Depression Inventory was used. Also, in the study by Saeedi et al., the elderly surveyed were retirees of the Ahwaz oil industry, while in the other study, not all of the subjects were retired from a particular organization. Not all individuals in Kashafi et al.'s study [35] (unlike Saeedi et al.'s study) did not use retirement benefits and thus may experience more economic and social problems and have less access to health care and support. This may be the cause of the difference in the prevalence of depression in the two mentioned studies.

4.1. Limitations

Despite the strengths of the study, restrictions such as not searching studies in languages other than Persian and English prevented access to all studies in this field.

5. Conclusion

According to the results of this study, depression in the Iranian elderly was moderate to high. Therefore, more exact assessment in terms of depression screening in elderly people seems necessary. According to the World Health Organization's motto of prevention prior to treatment, health managers can use the results of this study and emphasize to screen for depression in nursing homes as well as in rural health homes. Coherent and systematic programs, including psychosocial empowerment counselling for the elderly and workshops for their families, are also needed. Researchers can also use the results of this study for future research.

Acknowledgments

This study was approved by the Student Research Committee of the Mazandaran University of Medical Sciences with the ethical code of IR.MAZUMS.REC.1398.5930 (Grant no. 5930, dated 2019), and the authors acknowledge its financial support.

Data Availability

The data used in the study are available from the corresponding author upon request via e-mail.

Conflicts of Interest

The authors declare no conflicts of interest.

References

  • 1.Amaral T. L. M., Amaral C. D. A., Lima N. S. D., Herculano P. V., Prado P. R. d., Monteiro G. T. R. Multimorbidade, depressão e qualidade de vida em idosos atendidos pela Estratégia de Saúde da Família em Senador Guiomard, Acre, Brasil. Ciência and Saúde Coletiva. 2018;23(9):3077–3084. doi: 10.1590/1413-81232018239.22532016. [DOI] [PubMed] [Google Scholar]
  • 2.Camargo-Casas S., Suarez-Monsalve S., Zepeda M. UP., Garcia-Pena C., Cano-Gutierrez CA. Multimorbidity, depressive symptoms, and self-reported health in older adults: a secondary analysis of the sabe bogota study. Revista de investigacion clinica; organo del Hospital de Enfermedades de la Nutricion. 2018;70(4):192–197. doi: 10.24875/ric.18002478. [DOI] [PubMed] [Google Scholar]
  • 3.Al-Hashar A., Al Sinawi H., Al Mahrizi A., Al-Hatrushi M. Prevalence and covariates of polypharmacy in elderly patients on discharge from a tertiary care hospital in Oman. Oman Medical Journal. 2016;31(6):421–425. doi: 10.5001/omj.2016.85. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4.World Health Organization. World Health Organization. 2014. http://www.who.int/ageing/about/facts/en/ [Google Scholar]
  • 5.Mirzaie M., Darabi S. Population aging in Iran and rising health care costs. Salmand. 2017;12(2):156–169. doi: 10.21859/sija-1202156. [DOI] [Google Scholar]
  • 6.Peiman H., Yaghoubi M., Seyed Mohammadi A., Delpishe A. Prevalence of chronic diseases in the elderly in ilam. Salmand: Iranian Journal of Ageing. 2012;6(4):7–13. [Google Scholar]
  • 7.Eun-kyung W., Changsu H., Sangmee AJ., et al. Morbidity and related factors among elderly people in South Korea: results from the Ansan Geriatric (AGE) cohort study. BMC Public Health. 2007;7(10):1–9. doi: 10.1186/1471-2458-7-10. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 8.Sharifi M., Mohammad-Aminzadeh D., Soleimani sefat E., Sudmand N., Younesi J. Relationship of deterministic thinking with loneliness and depression in the elderly. Salmand. 2017;12(3):276–287. doi: 10.21859/sija.12.3.276. [DOI] [Google Scholar]
  • 9.Swathi G. Death anxiety, death depression, geriatric depression and suicidal ideation among institutionalized and noninstitutionalized elders. International Journal of Scientific and Research Publication. 2014;4(10):356–364. [Google Scholar]
  • 10.Alipour F., Sajadi H., Forouzan A., Nabavi H., Khedmati E. The role of social support in the anxiety and depression of elderly. Salmand: Iranian Journal of Ageing. 2009;4(1):1–48. [Google Scholar]
  • 11.Keshavarzi S., Ahmadi S. M., Lankarani K. B. The impact of depression and malnutrition on health-related quality of life among the elderly Iranians. Global Journal of Health Science. 2015;7:161–170. doi: 10.5539/gjhs.v7n3p161. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 12.Viscogliosi G., Andreozzi P., Chiriac I. M., et al. Depressive symptoms in older people with metabolic syndrome: is there a relationship with inflammation? International Journal of Geriatric Psychiatry. 2013;28(3):242–247. doi: 10.1002/gps.3817. [DOI] [PubMed] [Google Scholar]
  • 13. https://www.who.int/health-topics/depression#tab=tab_1.
  • 14.Ahmadzadeh G. Diagnosis and treatment of depression in elderly (emphasizing medical conditions in the elderly) Research in Behavioral Sciences. 2011;8(2):154–155. [Google Scholar]
  • 15.Mirzaei M., Sahaf R., Mirzaei S., Sepahvand E., Pakdel A., Shemshadi H. Depression and its associated factors in elderly nursing home residents: a screening study in khorramabad. Iranian Journal of Ageing. 2015;10(1):54–61. [Google Scholar]
  • 16.Vieira E. R., Brown E. Patrick R., Raue P. “Depression in older adults. Journal of Geriatric Physical Therapy. 2014;37(1):24–30. doi: 10.1519/jpt.0b013e31828df26f. [DOI] [PubMed] [Google Scholar]
  • 17.Khodadady N., Sheikholeslami F., Rezamasuoleh S., Yazdani M. Rate of depression in late-life in superannuated government employed center of Guilan University of medical sciences. Journal of Holistic Nursing and Midwifery. 2007;17(1):16–22. [Google Scholar]
  • 18.Bakhtiyari M., Emaminaeini M., Hatami H., Khodakarim S., Sahaf R. Depression and perceived social support in the elderly. Salmand. 2017;12(2):192–207. doi: 10.21859/sija-1202192. [DOI] [Google Scholar]
  • 19.Bock J.-O., Luppa M., Brettschneider C., et al. Impact of depression on health care utilization and costs among multimorbid patients - results from the MultiCare cohort study. PLoS One. 2014;9(3) doi: 10.1371/journal.pone.0091973.e91973 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 20.Saeedi M., Ghafarzadeghan R., Hekmatpou D. Perception of illness in patients undergoing hemodialysis: a qualitative study. Iran Journal of Nursing. 2017;30(108):60–71. doi: 10.29252/ijn.30.108.60. [DOI] [Google Scholar]
  • 21.Alizadeh M., Hoseini M., Shojaeizadeh D., Rahimi A., Arshinchi M., Rohani H. Assessing anxiety, depression and psychological wellbeing status of urban elderly under represent of tehran metropolitan city. Salmand: Iranian Journal of Ageing. 2012;7(3):66–73. [Google Scholar]
  • 22.Ghafari M., Sharifirad G. R., Zanjani S., Hassanzadeh A. Stress, anxiety and depression levels among elderly referrals to tehran elderly club. Salmand: Iranian Journal of Ageing. 2012;7(2):53–59. [Google Scholar]
  • 23.Sarokhani D., Parvareh M., Hasanpour Dehkordi A., Sayehmiri K., Moghimbeigi A. Prevalence of depression among Iranian elderly: systematic review and meta-analysis. Iranian Journal of Psychiatry. 2018;13(1):55–64. [PMC free article] [PubMed] [Google Scholar]
  • 24.Miller J. J. The Inverse of the freeman - tukey double arcsine transformation. The American Statistician. 1978;32(4):p. 138. doi: 10.1080/00031305.1978.10479283. [DOI] [Google Scholar]
  • 25.Team R. A Language and Environment for Statistical Computing. Vienna, AT, USA: R Foundation for Statistical Computing; 2019. https://wwwR-projectorg. [Google Scholar]
  • 26.Viechtbauer W. Conducting meta-analyses in R with the metafor package. Journal of Statistical Software. 2010;36(3):1–48. doi: 10.18637/jss.v036.i03. [DOI] [Google Scholar]
  • 27.Gharanjik A., Mohammadi Shahbolaghi F., Ansari G., et al. The prevalence of depression in older turkmen adults in 2010. Sija. 2011;6:34–39. [Google Scholar]
  • 28.Manzouri L., Babak A., Merasi M. The depression status of the elderly and it’s related factors in isfahan in 2007. Sija. 2010;4 [Google Scholar]
  • 29.Mobasheri M., Moezy M. The prevalence of depression among the elderly population of Shaystegan and Jahandidegan nursing homes in Shahrekord. Journal of Shahrekord University of Medical Sciences. 2010;12:89–94. [Google Scholar]
  • 30.Ashrafi K., Sahaf R., Mohammadi Shahbalaghi F., et al. Prevalence of depression in Turk azeri older adults of Iran. Journal of Sabzevar University of Medical Sciences. 2017;23(23):856–865. doi: 10.21859/sums-2306856. [DOI] [Google Scholar]
  • 31.Payahoo L., Khaje-bishak Y., Pourghassem Gargari B., Kabir-alavi M., Asghari Jafarabadi M. Nutritional status and its relation with depression in free-living elderly individuals. Medical Journal of Tabriz University of Medical Sciences and Health Services. 2013;35:20–25. [Google Scholar]
  • 32.Alahyari T., Mirgholikhani Tehrani N. A study of social factors affecting depression among elderly women living in Kahrizak sanatorium. Social sciences. 2014;74 [Google Scholar]
  • 33.Nejati V., Ashayeri H. Evaluation of relationship between depression and cognitive impairment in elderly. Sija. 2007;1:112–118. [Google Scholar]
  • 34.Rajabizadeh G., Ramazani A. Prevalence of depressionin kermanian geriatrics (2002) Journal of Rafsanjan University of Medical Sciences. 2003;3:58–66. [Google Scholar]
  • 35.Kashfi S., KhaniJeihooni A., Farhadi S. The relationship between social and demographic factors and prevalence of depression among over 60 years old individuals, Shiraz, Iran. Hormozgan Medical Journal. 2011;14(4):319–325. [Google Scholar]
  • 36.Ghaderi S., Sahaf R., Mohammadi Shahbalaghi F., et al. Prevalence of depression in elderly Kurdish community residing in boukan, Iran. Sija. 2012;7:57–66. [Google Scholar]
  • 37.Saeedi S., Foroughan M., Akbari Kamrani A. Clinical features of elderly patients admitted to Ahvaz petroleum hospital. Quarterly Journal of Sabzevar University of Medical Sciences. 2012;19:85–95. [Google Scholar]
  • 38.Sharifzadeh G., Moodi M., Akhbari H. Investigating health status of older people supported by imam. Sija. 2010;5:52–59. [Google Scholar]
  • 39.Taheri Tanjanai P., Moradinazar M., Najafi F. Prevalence of depression and related social and physical factors amongst the Iranian elderly population in 2012. Geriatrics and Gerontology International. 2017;17(1):126–131. doi: 10.1111/ggi.12680. [DOI] [PubMed] [Google Scholar]
  • 40.Ahmadi Ahanga A., Saadat P., Hosseini R., Tghipour M., Eftari M., Bijani A. Association of physical activity, depression and some demographic features with cognitive impairments in an elderly population in amirkola, north of Iran. Journal of Mazandaran University of Medical Sciences. 2017;27(153):49–63. [Google Scholar]
  • 41.Babazadeh T., Sarkhoshi R., Bahadori F., Moradi F., Shariat F., Sherizadeh Y. Prevalence of depression, anxiety and stress disorders in elderly people residing in Khoy, Iran (2014-2015) Journal of Analytical Research in Clinical Medicine. 2016;4(2):122–128. doi: 10.15171/jarcm.2016.020. [DOI] [Google Scholar]
  • 42.Sadeghi M., Bazghaleh M. The relationship between depression and quality of life among elderly of nursing home residents and non-residents in Shahroud city. Journal of Knowledge and Health. 2017;12(1):8–15. [Google Scholar]
  • 43.Khalili Z., Taghadosi M., Heravi-Karimooi M., Sadrollahi A., Gilasi H. Assessment of the associations of depression with elder abuse among the elderly in Kashan City, Iran. Salmand: Iranian Journal of Ageing. 2016;10(4):8–17. [Google Scholar]
  • 44.Emaminaeiani M., Bakhtiyari M., Hatami H., Khodakarim S., Sahaf R. Depression and perceived support social in the elderly. Iranian Journal of Ageing. 2017;12(2):192–207. [Google Scholar]
  • 45.Nazemi L., Skoog I., Karlsson I., et al. Depression, prevalence and some risk factors in elderly nursing homes in tehran, Iran. Iranian journal of public health. 2013;42(6):559–569. [PMC free article] [PubMed] [Google Scholar]
  • 46.Mokhber N., Majdi M., Ali-Abadi M., et al. Association between malnutrition and depression in elderly people in razavi khorasan: a population based-study in Iran. Iranian journal of public health. 2011;40(2):67–74. [PMC free article] [PubMed] [Google Scholar]
  • 47.Hosseini S. R., Zabihi A., Ebrahimi S. H., Jafarian Amiri S. R., Kheirkhah F., Bijani A. The prevalence of anemia and its association with depressive symptoms among older adults in north of Iran. Journal of Research in Health Sciences. 2018;18(3)e00431 [PMC free article] [PubMed] [Google Scholar]
  • 48.Majdi MR., Ghayour-Mobarhan M., Salek M., Shakeri MT., Mokhber N. Prevalence of depression in an elderly population: a population-based study in Iran. Iranian Journal of Psychiatry and Behavioral Sciences. 2011;5(1):17–21. [Google Scholar]
  • 49.Hassanpoor Dehkordi A., Malekpoor F., Hosseiny RS., Rafiei H. Prevalence of depression among older adults with renal stone in who admitted to Kashani hospital in Shahrekord, 2013. Journal of Clinical Research in Paramedical Sciences. 2014;3(3):188–195. [Google Scholar]
  • 50.Karami N., Rezai J., Jozanifar Y., et al. A survey of the depression rate among the elderly in Kermanshah, 2012. Journal of Clinical Research in Paramedical Sciences. 2016;5(1):15–22. [Google Scholar]
  • 51.Wang J., Wu X., Lai W., et al. Prevalence of depression and depressive symptoms among outpatients: a systematic review and meta-analysis. BMJ Open. 2017;7(8) doi: 10.1136/bmjopen-2017-017173.e017173 [DOI] [PMC free article] [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The data used in the study are available from the corresponding author upon request via e-mail.

Articles from Journal of Aging Research are provided here courtesy of Wiley

RESOURCES