Table 1.
Characteristics of included studies
| Author/year | Intervention description | Country | Type of study/Study design | Population group (sample size, age ranges) | Length and frequency of intervention | Comparison group | Outcomes and assessment methods | Follow up time point | Findings |
|---|---|---|---|---|---|---|---|---|---|
| Therapy | |||||||||
| Established forms of short-term therapy | |||||||||
| Siviş and Demir (2007) [58] | Reminiscence therapy program | Turkey | quasi-experimental, controlled study and focus group interview with the intervention group participants Focus group interviews | 10 participants with 5 in each group. Mean age: intervention 68 years and control 73 years | Not reported | No intervention |
LSI A – Life satisfaction Analysis approach for qualitative data not reported |
post intervention |
No significant difference between post-test Life Satisfaction scores of older adults in intervention group compared to control group Participants reported positive feedback regarding the group experience, e.g., group’s role in facilitating interaction and friendship among participants, enhancing a more positive self-image and leading to enjoyment and pleasant feelings |
| Cherian (2019) [7] | Reminiscence therapy | India | pretest–posttest study | 50 older adults aged 60–80 years residing in greater Noida, Uttar Pradesh | Not reported | GDS long form—Depression | not reported | significant reduction in depressive symptoms | |
| Efendi et al. (2020) [8] | Cognitive behaviour therapy (CBT) | Indonesia | Randomised control trial | 90 older adults > 60 years old living in the post-earthquake Lombok area experiencing PTSD based on the Clinician-Administered PTSD Scale (CAPS-5), GDS ≥ 5 and MMSE ≥ 24. 45 respondents in the intervention group and 45 respondents in the treatment group | Not reported | no intervention | Clinician-Administered PTSD Scale (CAPS-5)—post-traumatic stress disorder; GDS – depression and WHO Quality of Life-BREF – Quality of Life | 6 weeks | decrease in post-traumatic stress disorder and depression scores, significant improvement in quality-of-life components |
| Saisanan Na Ayudhaya et al. (2020) [46] | Behavioural activation sessions delivered subsequently included (1) activity monitoring- examining the effect of specific activities on mood, (2) activity scheduling-developing a plan to increase pleasant activities, and (3) modification-utilizing problem-solving to alter contextual problems that may be eliciting or maintaining depressed mood | Thailand | quasi-experimental, controlled study | 82 older adults aged 60 years and above from two subdistricts of Muang district of Samut Songkram Province who were diagnosed with subthreshold depression GDS score between 13 and 24. 41 older adults from each district was enrolled into the study | 12 weeks | Regular physical examinations, review of current health symptoms, and psychoeducation delivered by the local mental health nurse | Thai GDS- Depression; DASS- Anxiety | 3, 6,and 9 months follow up | significant reductions in the TGDS score and DASS compared to usual care-only group. Lower TGDS and DASS depression and stress scores maintained up to 6 months. Reduction in DASS anxiety score maintained only for 3-month post-intervention |
| Li et al. (2021) [30] | group reminiscence therapy based on Chinese traditional festival activities. participants attended a four-hour intervention session | China | Randomised control trial | 64 Chinese rural older adults (aged 65.70 ± 3.69 years) living alone with 32 individuals each in the intervention group and the wait-list control group | one session each month for 8 months | no intervention | Perceived stress scale—Perceived stress; UCLA loneliness scale—loneliness | 3 months | significantly decreased the perceived stress and loneliness of rural older adults living alone in intervention group compared to control group post intervention and at 3 months follow up |
| Yujia et al. (2021) [36] | group reminiscence therapy intervention in combination with physical exercise | China | Randomised control trial | 130 older adults aged 60 years and above from communities in Xiangtan City and Changsha City of Hunan Province, with 65 people in each group | 8 weeks | listened to 4 routine health lectures | Spirituality Index of Well-Being—spiritual well-being; ULS Loneliness Scale—loneliness and Brief Resilience Scale – resilience | post intervention (8th week) | Reduction in loneliness and improvement in the spiritual well-being and resilience in the intervention compared to control group |
| Sutinah (2020) [47] | Psychoeducation therapy was done first and then followed by reminiscence therapy in the next day | Indonesia | quasi-experimental, controlled study | 72 older adults in the Simpang Kawat Village, Jambi Indonesia. 36 in the intervention group and 36 in the comparison group. The average age of participants in the intervention and control groups was 68 years |
Psychoeducation therapy:5 sessions with 5 meetings, and each session for 45–60 min Reminiscence therapy: 5 sessions with 9 meetings and each session for 75 min. The intervention lasted for 6 weeks |
reminiscence therapy | Indonesian version of GDS—depression | post intervention |
Reminiscence therapy alone or in combination with psychoeducation therapy effective in reducing depression. The combination of reminiscence and psychoeducation therapy was much more effective than reminiscence therapy alone |
|
Yuan et al. (2020) |
Adapted Cognitive behaviour therapy delivered by trained lay health workers | China |
Randomised control trial Focus group and in-depth interviews |
50 older adults (age: mean 70.5 ± 5.6 years) with Geriatric depression scale score > 9: 24 to the Cognitive behaviour therapy group and 26 to the Control group | Eight sessions | usual care |
GDS– depression; Self-rating Anxiety Scale – anxiety and WHO Quality of Life-BREF—social relationships Qualitative data analysed based on thematic framework was developed and agreed on by consensus |
week 4 and week 8 (or after the eighth session) |
Cognitive behaviour therapy reduced more Geriatric Depression scores over 8-week follow-up compared with usual care The village doctors stressed the importance of role-playing and using instructive manuals in the training. Proper supervision was also a key component of the program. Cultural and political factors facilitated the elders’ access to mental health services. Challenges included a lack of real therapy (in contrast to role-playing) demonstrated in the training and lack of a step-by-step manual based on different types of problems encountered |
|
Viguer et al. (2017) [48] |
reminiscence program conducted by a trained psychologist | Dominican Republic | quasi-experimental, controlled study | 168 healthy older adults aged 60 years and above recruited through four healthcare centers with no clinical depression (determined by a score of 14 or less on the Geriatric depression scale Spanish version). 84 in each group | 10 weekly group sessions lasting two hours each | No intervention |
Spanish version of GDS– depression; LSI-A – life satisfaction; Spanish version of the Psychological Well-Being Scales – psychological well-being |
post intervention and at three months follow up | significant increases in the time-group interaction, life satisfaction, and psychological well-being measures, and decreases in depressed mood, after treatment. The effects remained after three months in the case of life satisfaction and some dimensions of psychological well-being, but they were lower on depressed mood |
| Xie et al. (2019) [34] | Modified behavioural activation treatment and regular treatment | China | randomised control trial | Eighty rural left-behind older adults, aged 60 years and above in Yankoutown town of Lengshuijiang City, Hunan Province who had a GDS score between 11 and 25. 40 participants in each group | 8 weeks | received regular treatment | GDS—long form – depression; Beck Anxiety Inventory—anxiety and OHQ- happiness | post-intervention, and at 3 months post-intervention | GDS and BAI scores decreased significantly, but the scores of OHQ increased significantly in the intervention group. The reduction in depression symptoms after the intervention was maintained at the 3-month follow-up |
| Zhou et al. (2012) [40] | health education and group reminiscence therapy by trained community nurses | China | cluster randomised control trial | 129 older adults (8 communities) with 62 participants (4 communities) in the intervention group (4 communities) and 67 participants in the control group. average age of participants was 69.4 years | Once a week, for 90–120 min per session, and lasted for 6 weeks | three health education sessions—one every 2 weeks lasting 30–45 min each | GDS -depression; Self-Esteem Scale – self-esteem and Affect Balance Scale – affect balance | postintervention (6 weeks) | Depression scores in the intervention group decreased significantly compared to those in the control group. Scores on the positive affect subscale and affect balance in the intervention group increased significantly higher than control group, and scores on the negative affect subscale decreased significantly lower than control group |
| Other forms of therapy | |||||||||
| Amigo and Mariati (2020) [51] | Classical music versus music-video therapies | Indonesia | pretest–posttest study with two intervention groups | 24 older adults aged 60 years and over who experienced stress (Depression Anxiety Stress Scale score > 14), with 12 older adults in each group | DASS—stress | not reported | Significant effectiveness of both music and music video therapy in reducing stress in older adults | ||
| Goksin and Asiret (2021) [29] | Progressive muscle relaxation that involves the controlled contraction and relaxation of large muscle groups in the human body along with regular breathing | Turkey | Randomised control trial | 49 elderly women aged 65 and over who were not diagnosed with dementia or psychiatric illness (21 intervention and 28 controls) from a family health centre | 28 min sessions three times a week for 8 weeks | no intervention | GDS– depression | post intervention (8th week) | a significant difference in the mean depression scores in the intervention group |
| Dias, Azariah, Anderson, et al. (2019) [55, 60–63] | Lay counsellors provided problem-solving therapy, brief behavioural treatment for insomnia, education in self-care of common medical disorders such as diabetes, and assistance in accessing medical and social programs | India |
Randomised control trial semi structured, in-depth interviews with participants in the intervention arm |
181 older adults (≥ 60 years) with subsyndromal depressive symptoms at rural and urban primary care clinics in Goa. with 91 participants in the intervention group and 90 in control group | Six intervention sessions, 30 to 40 min in length that spanned 6 to 10 weeks including 2 booster sessions, 1 each at months 7 and 10 | Care as usual |
Mini International Neuropsychiatric Interview 6.0; Depression (GHQ-12) Framework analysis (qualitative data) |
12 months |
Incident episodes of major depression lower in the intervention. The incidence of depressive symptoms was also less Participant Perceptions of the Psychoeducation and Active Coping Strategies, Engagement with the Lay Counsellor, Coping with Physical Health Issues, Engaging in More Pleasurable Activities, Improving Sleep Quality, Using Strategies to Reduce “Tension”, Where the Intervention Was Not Perceived to Be Helpful and Participant Recommendations |
| Esmaeilzadeh and Oz (2020) [52] | Psychosocial care intervention delivered once a week group meeting session in total of nine sessions. The intervention used visual methods, question answer and discussion technique, homework, and warming games to address emotional, social, and physical problems that the elderly faced | Turkey | pretest–posttest study | 44 older adults who are 65-year and above registered in the elderly day care center | each session lasted approx.. 2 h | GDS short form – depression; Turkish version of the WHO Quality of Life Instrument—Health-Related Quality of Life; UCLA loneliness scale—loneliness | post intervention | significant reduction in loneliness and improvement in quality of life but no significant reduction in depression | |
| Exercise | |||||||||
| Ansai and Rebelatto (2015) [21] | Multicomponent training session: warm-up using cycle ergometer; aerobic exercise using cycle ergometer; strength exercises of major muscle groups; balance activities; and cool-down exercise. Resistance training group carried out three sets of 10–12 maximal repetitions, with moderate speed and 1-min resting periods between sets | Brazil | Three arm randomised control trial | 69 community-dwelling older adults aged 80 years and older from São Carlos with 23 in each group | 16 weeks and included three 1-h sessions per week on non-consecutive days | No intervention | GDS—Depression | Post intervention (16 weeks) | No significant differences between groups on Geriatric depression scale |
| Azizan and Justine (2016) [41] |
Exercise behaviour group: group-based exercise followed by behavioural program Exercise group: only the exercise training. conducted |
Malaysia | quasi-experimental, controlled study | 63 older adults aged 60 and over recruited from three different villages. (a) exercise and behavioural program group (n = 18), (b) exercise only group (n = 23), and (c) control group (n = 22) |
Exercise: three sessions per week, each session of 1 h for 6 weeks Behavioural programme: two times per week for 5 weeks |
advised to continue with their normal routines | Malay version of the GDS – Depression; SF-12 Health Survey – Health-related quality of life | 12 weeks and 24 weeks | Significant main effect only in the level of depression among the three groups for Health-related quality of life, a significant main effect was found on the physical and mental component score |
| Borbon-Castro et al. (2019) [42] | In a multidimensional exercise program, exercise classes were offered 5 days a week for 12 weeks with a total of 60 sessions. Each session lasted for 60 min, including a warm-up, a variety of exercises, and cool-down. The 12-weeks exercise sessions were divided in to six modules which increased in intensity every two weeks | Mexico | quasi-experimental, controlled study | 45 older adults living in the urban community, intervention group (n = 23) and control group (n = 22). The mean age was 67.7 years for intervention and 66.6 for control group | 12 weeks | advised to continue performing the activities of the center in which they were registered | GDS—Depression | 1 week after the conclusion of intervention | Depression decreased in the intervention group |
| Ibrahim et al. (2021) [53] | daily virtual group exercise | Malaysia | pretest–posttest study | Elderly aged 60 years and above recruited from the Promoting Independence in Seniors with Arthritis pilot cohort | 4 weeks | Hospital Anxiety and Depression Scale – Anxiety and depression | post intervention | No significant difference in anxiety and depression scores before and after intervention | |
| Moraes et al. (2020) [22] | Aerobic training group performed aerobic exercise on stationary bikes or treadmills. The strength training group performed exercises for the major muscle groups | Brazil | Three arm randomised control trial | 27 outpatients from the Center for Alzheimer’s Disease and Related Disorders from the Institute of Psychiatry at the Federal University of Rio de Janeiro. 9 in each group | Both groups had to perform 30 min of moderate intensity physical exercise and had to attend at least 75% of the 24 sessions in 12 weeks | 30 min of low-intensity exercise for 12 weeks | HDRS and BDI- depression | Post intervention | Aerobic training and strength training groups showed significant reductions in depressive symptoms |
| Ojha and Yadav (2016) [31] | yogic techniques | India | Randomised control trial | 500 subjects who were retired officials (in the age group of 65–75 years), 250 in each group from municipal areas of 12 towns of eastern Bihar | half an hour daily for six months | Usual activities | Composite psychological wellbeing score – psychological well-being | post intervention | Significant improvement in composite psychological wellbeing score in intervention group |
| Prakhinkit et al. (2014) [32] | The Buddhist walking meditation program based on aerobic walking exercise incorporating the Buddhist meditations. Traditional walking exercise program involved walking at mild intensity | Thailand | Three arm randomised control trial | Forty-five elderly participants aged 60–90 years with mild-to-moderate depressive symptoms were recruited from university hospital. 15 in each group | Both interventions were performed for 20 min, 3 times/week for 12 weeks | Usual activities | Thai version of GDS (long form)—depression | post intervention | Depression score decreased only in the Buddhist walking meditation group |
| Shahidi et al. (2011) [33] | laughter yoga (10 sessions) and group exercise program (10 sessions) | Iran | randomised control trial | Seventy depressed old women aged 60–80 years from cultural community of Tehran with GDS score > 10. Laughter Yoga (n = 23), exercise therapy (n = 23), and control groups (n = 24) | No intervention | GDS – depression; Diener life satisfaction scale – Life satisfaction | post intervention | significant decrease in depression scores of both Laughter Yoga and exercise therapy group in comparison to control group. There was no significant difference between Laughter Yoga and exercise therapy groups | |
| Chua and de Guzman (2014) [26] | program consisting of wellness, physical fitness, and livelihood training activities facilitated by volunteer faculty from a local university | Philippines | Randomised control trial | 40 community dwelling Filipino elderly aged 60–80 years. Twenty-five subjects were assigned to the intervention group while 15 subjects to the control group | 4 months | no intervention | Life Satisfaction Index for the Third Age Short Form (LSITA-SF)—Life satisfaction and GDS—Depression | 4 months | The intervention group had significantly higher LSITA-SF scores after the program than before it was implemented and a significant decrease in the depression level |
| Ghodsbin et al. (2015) [28] | Laughter therapy, including performing breathing and physical exercises as well as laughter techniques | Iran | Randomised control trial | 72 senior citizens aged 60 and over referring to Jahandidegan (Khold-e-Barin) retirement community center in Shiraz. With 36 participants in each group | Consists of two 90-min sessions per week over 6 weeks | No intervention | General Health Questionnaire (GHQ-28) | post intervention | significant improvement in mean scores for anxiety but no significant improvement in mean scores for depression in the intervention group compared to the control group |
| Xu et al. (2016) [35] | Collective exercise intervention that included Baduanjin (Chinese gymnastics) and elderly ballroom dancing | China | randomised control trial | 115 elderly hypertensive patients aged 60–70 years old from Fuzhou City, Fujian Province. With 58 participants in Intervention group and 57 in control group | 12 weeks | No intervention | Symptom checklist 90- mental disorders and psychological illnesses | post-intervention | After intervention, the Symptom Checklist-90, total score, somatization, obsessive–compulsive symptom, interpersonal sensitivity, depression, anxiety, hostility, and paranoia scores of the intervention group were significantly lower than those of the control group |
| Social engagement | |||||||||
| Aekwarangkoon and Noonil (2020) [35] | weekly positive interpersonal interactions with grandchildren and older adults involving using words of affirmation, spending quality time, offering gifts, performing acts of service and communicating emotional love through physical contacts | Thailand | Cluster randomised control trial | 80 older adults aged 60-year and above, living in 4 villages of Thasala District, Nakhon Si Thammarat Province, with 40 older adults in each group | Six weeks | Usual care | Nine-Question Scale and HDRS- depression | at 6th, 12th and 24thweek follow-up | a significant decline in Hamilton Rating Scale scores after grandchildren’s love language program |
| Jacob et al. (2007) [44] | Community based day care which included recreational activities, occupational therapy, counselling services, medical services and a noon meal | India | quasi-experimental, controlled study | 41 elderly residents of Pennathur village whose scores were in the lowest third on the socioeconomic status scale and on the social support scale | no intervention | WHO Quality of Life—BREF – Quality of Life | 3 months | a significant improvement in quality-of-life scores in those who attended day care compared to those who did not attend (p < 0.001) | |
| Malekafzali et al. (2010) [54] | community mobilization of trained volunteers who were assigned to following tasks: home visits and face to face elderly education, referral to physicians for elderly with health problems, distribution of educational pamphlets, a general meeting question and answer session with the presence of the experts | Iran | pretest–posttest study | 200 elderly patient aged 60 years and over | Life satisfaction (No standard validated questionnaires were used) | Post intervention | No significant findings | ||
| Rachasrimuang et al. (2018) [39] | Trained youth volunteers were assigned for home visit to the same 6 to 7 elderly persons’ households | Thailand | Cluster randomised control trial | elderly persons, aged 60 years and over living in the study area in 9 villages of Mainapiang Sub-district, Wangyai District, Khon Kaen province | 18 weeks | received conventional care by their family and children | Thai version GDS – depression; Thai version of the EQ-5D-5L developed by Mahidol University—Health-related quality of life | 9th week and 12th week follow up from baseline measurement | significant reduction in depression scores in intervention group compared to control groups in the 9th-week and 18th-week follow-up. There was significant improvement in self-health perception in overall health status in intervention group compared to control group in the 18th week |
| Education | |||||||||
| Moeini et al. (2020) [9] | Four weekly educational training sessions, each session lasting 60 min comprising of lectures, group discussions, colloquy, booklets and educational pamphlets by experts | Iran | quasi-experimental, controlled study | 100 older adults aged 60‐75 years in Hamadan with 40 participants in intervention group and 60 participants in control group | no intervention | Persian version of Oxford Argyle Happiness Inventory – happiness and a questionnaire derived from social support questionnaire | 3 months | a significant improvement in the scores of happiness, social support and their components in the intervention group compared to the control group three months after the intervention | |
| Wang et al. (2019) [49] | Mental health lecture and training in a nurse-led Path-oriented Psychological Self-help Intervention | China | quasi-experimental, controlled study | 76 empty-nest older adults from 2 districts in the city of Chifeng. 38 in each group | 1 month | mental health lecture | Chinese Mental Health Scale (geriatric edition)—mental health status | 3 months | The mental health status scores improved in the intervention group 1 month after baseline and sustained for 3 months after the intervention |
| Yodmai et al. (2021) [10] | Health promotion program that trained family member of older adults to change health behaviours such as eating healthy food, exercising, emotion management and disability preventive activities | Thailand | quasi-experimental, controlled study | Fifty-five older adults aged 60–80 years with chronic diseases, including hypertension, diabetes, hyperlipidaemia, and heart disease in Khon Kaen Province | 12 months |
usual health promoting activities by health personnel |
WHO-Quality of life measurement – Quality of Life; 30-item GDS- depression | postintervention at 9th and 12th months | After the intervention, social support and perception of health care from family members were significantly improved at the 9th month. At the 12th month, overall Quality of life, sensory ability, social participation, intimacy, social support, and perception of health care from family members significantly improved. Depression was also reduced at the 12th month |
| Other/Multi-component | |||||||||
| Abdi et al. (2019) [25] | a religion-spiritual program that included strategies such as reading verses from the Holy Quran and spiritual caring services | Iran | Randomised control trial | 100 Older adults with cardiovascular disease from Mostafa–Khomini hospital having a religion of Islam-Shia, 50 older adults in each group | Six educational sessions, each in a week and lasted about 30–45 min | No intervention | BDI– depression; LSI-Z—Life satisfaction | 3 months | Higher mean life satisfaction scores and lower mean depression scores in intervention group than control group post intervention |
| Carandang et al.(2020) [43] |
Peer counselling group: Peer counsellors performed 1-h home visits weekly to their assigned clients Social engagement group: Senior citizens joined 3-h weekly social events held at the OSCA Center Combination group: both peer counselling and social engagement interventions |
Philippines | 4-arm quasi-experimental, controlled study | 270 community-dwelling Filipino senior citizens with mean age was 68.3 years, who had tendency towards depression based on the 15-item Geriatric Depression Scale. peer counselling (n = 65), social engagement (n = 66), and combination (n = 65) and control group (n = 68) | 3 months |
usual or standard care from health and aged care services |
GDS—Depression. 8-item UCLA Loneliness Scale—Loneliness | 3 months | Social engagement and combined intervention had a large effect on reducing depressive symptoms while peer counselling had only moderate effect. All interventions had only small effect on improving loneliness |
| Ebrahimi et al. (2020) [27] | In one group, older adults received intergenerational programs plus aerobic exercises in the presence of young adults, and in other group they received intergenerational programs only | Iran | Three arm randomised control trial | 150 older adults (mean age, 71.4 years) and 100 students (mean age, 21.8 years) living in Mashhad | 8 weeks | Daily routine activities | WHO Quality of Life, BREF – Quality of Life | postintervention at 8 weeks from baseline assessment | a significant difference in the mean scores of quality-of-life dimensions between the three groups |
| Zhan et al. (2018) [50] | mental health services including knowledge about healthy mental state, psychological consultation/treatment, and access to a psychiatric hotline | China | quasi-experimental, controlled study | 2,000 elderly residents, aged 60 years and above in the Longhua sub-district of Shanghai | 1 year | Only the basic mental health services | Generalized Anxiety Disorder 7-item scale – Anxiety and depression; PHQ-9 and Quality of Life Index – quality of life and General Well-Being Schedule (GWB) – wellbeing | 6 months and 12 months | PHQ-9 and GAD-7 scores gradually decreased and GWB score gradually increased in intervention group. After 12 months, compared the control group, the scores of subscales in GWB satisfaction and interest in life, worries about health, depressed versus cheerful mood, and relaxation versus tension (anxiety) were significantly better |
| Rana et al. (2009) [45] | Community based intervention that included physical activity, advice on healthy food intake and other aspects of management. Social awareness was provided by means of information about the contribution of and challenges faced by older adults at home and the community, including information about older adults’ health and health care. Intervention activities provided to older adults, caregivers, household members and community people | Bangladesh | quasi-experimental, controlled study | 839 elderly persons (≥ 60 years) eight randomly selected villages (Intervention: n = 4; Control: n = 4) in rural Bangladesh. 425 elderly persons in the intervention group and 414 in the control group | 15 months | No intervention | Health related quality of life – generic instrument | 3 months after intervention | significant differences noted in the physical, social, spiritual, environment and overall Health related quality of life |
| Zhang et al. (2021) [37] | Self-Mutual-Group based intervention, which consisted of three stages: self-management (2 months), mutual management (2 months), and group-management (3 months) | China | randomised control trial | 396 empty-nest older adults in Taiyuan, Shanxi. With 204 participants in the intervention group and 192 in control group | 7 months | No intervention | Short Form 36-Item Health Survey – Quality of Life | postintervention (7th month) | After the intervention, participants’ scores on Mental Component Summary, Physical Component Summary, role emotional, vitality, social function, mental health and general health increased significantly in the intervention group |
| Li et al. (2020) [56, 64] | The Collaborative Care for Older People with Comorbid Hypertension and Depression (COACH) model integrates the care provided by the older person's primary care provider (PCP) with that delivered by an Aging Worker (AW) from the village's Aging Association, supervised by a psychiatrist consultant | China | Five focus groups: two with VDs, two with AWs, and one with psychiatrists | iterative process | Facilitators to implementation include training, leaders’ support, geographic proximity between VD and AW pairs, pre-existing relationships among care team members, comparability of COACH activities and existing practices of VDs and AWs, and care team members’ caring about older members of their villages. Barriers to sustainability include frustration of some VDs related to their low wages and feelings of overload of some AWs | ||||
Legend. DASS Depression Anxiety Stress Scales, GDS Geriatric depression scale, WHO World Health Organization, LSI Life Satisfaction Index A, HDRS Hamilton Depression Rating Scale, BDI Beck Depression Inventory, OHQ Oxford Happiness Questionnaire.