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Highlights • The prevalence of severe anxiety (19.0%), severe depression (32.8%) and severe cognitive disorders (25.8%) among urban elderly in Berhampur city in Odisha, India was alarming. • Age, gender, education and social support system are significantly associated with these mental conditions. • Insufficient service providers, poor community awareness and social stigma were systemic challenges. • Physical activity, educational support and elderly-friendly environment need to be fostered. • Interventions at 'family' level for better participation of elderly in decision making need to be facilitated. Abstract Introduction Growing geriatric mental health needs of urban population in India pose several programmatic challenges. This study aimed to assess anxiety, depression and cognitive disorders among urban elderly, and explore availability of social support mechanisms and of a responsive health system to implement the national mental health programme. Methods 244 respondents were randomly selected from Berhampur city. We administered a semi-structured interview schedule to assess substance abuse, chronic morbidity, anxiety, depression and cognitive abilities. Further, in-depth interviews were conducted with 25 key informants including district officials, psychiatrists, and programme managers. We used R software and 'thematic framework' approach, respectively, for quantitative and qualitative data analysis. Ethical standards were complied with. Results About half of the respondents were economically dependent; 57.3% had moderate to severe anxiety; 46.7% had moderate to severe depression; while about 25% had severe cognitive impairments. We found association of chewing tobacco (1.34(0.28–2.40)) and depression (0.52(0.37–0.68)) with anxiety; negative perception about elderly-friendly society (1.64(0.75–2.53)) and physical inactivity (2.88(1.60–4.16)) with depression; and age (-0.11(-0.20 – -0.02)) and physical inactivity (-3.44(-5.13 – -1.74)) with cognitive disorders. Qualitative analysis revealed lack of awareness, social stigma, poor availability of trained human resources, and poor political commitment as important systemic barriers to early detection and treatment of mental ailments among the elderly. Conclusion Establishing tobacco cessation centres, sensitizing community about mental health needs of elderly, incentivizing physical activity of elderly, integrating mental health with primary care, multi-skilling providers and developing a cadre of community counsellors need urgent attention of policy makers and programme implementers. [ABSTRACT FROM AUTHOR]

Background & objectives: The population of elderly is growing globally and so are the physical illnesses and psychiatric morbidity. This study was planned to assess the prevalence and patterns of psychiatric morbidity amongst rural older adults in Lucknow, north India. Methods: A survey was conducted in subjects aged 60 yr and above to identify the cases of psychiatric morbidity in rural population from randomly selected two revenue blocks of Lucknow district, Uttar Pradesh, India. All subjects were screened through Hindi Mental Status Examination (HMSE) and Survey Psychiatric Assessment Schedule (SPAS) to identify for the suspected cases of cognitive and the psychiatric disorders, respectively. The subjects screened positive on HMSE and SPAS were assessed in detail on Cambridge Mental Disorder of the Elderly Examination-Revised (CAMDEX-R) and Schedule for Clinical Assessment in Neuropsychiatry (SCAN), to diagnose cognitive disorders and psychiatric disorders (other than the cognitive), respectively on the basis of International Classification of Diseases-10 (ICD-10) diagnostic guidelines. Results: The overall prevalence of psychiatric morbidity in rural older adults was found to be 23.7 per cent (95% CI=21.89-25.53). Mood (affective) disorders were the commonest (7.6%, 95% CI=6.51-8.80), followed by mild cognitive impairment (4.6%, 95% CI=3.72-5.53), mental and behavioural disorders due to substance use (4.0%, 95% CI=3.17-4.87) and dementia (2.8%) [Alzheimer's disease (2.4%, 95% CI=1.81-3.16) and vascular (0.4%, 95% CI=0.16-0.73)]. Interpretation & conclusions: Overall prevalence of psychiatric morbidity amongst rural elderly in this study was found to be less in comparison to those reported in earlier studies from India. However, prevalence pattern of different disorders was found to be similar. Therefore, it appears that a stringent methodology, reined case criteria for diagnosis and assessment by trained professionals restrict false diagnosis. [ABSTRACT FROM AUTHOR]

Background/Aims: To evaluate the ApoE gene polymorphism among patients with dementia from southern India. Methods: Persons with dementia attending a geriatric clinic in a hospital setting located in southern India and matched controls were recruited. All subjects were evaluated on standard assessments and were diagnosed according to the ICD-10; genotyping was done at the apolipoprotein E (ApoE) locus. Results: The study comprised 212 cases and 195 controls. The ApoE4 allele was significantly more prevalent in dementia (λ = 0.18 vs. λ = 0.07; p = 0.0018), especially in the Alzheimer's disease subgroup (n = 137; λ = 0.21 vs. λ = 0.07; p < 0.001), with a trend in vascular dementia subtype (n = 31; λ = 0.17 vs. λ = 0.07) in comparison with the control group. ApoE4 carrier status did not differ between the other dementia group (n = 44) and controls (p > 0.20), or between the Alzheimer's group and vascular dementia groups. Cognitive and functional deficits were not correlated to the presence ApoE4 polymorphism in the dementia group. Conclusion: The study confirmed the positive association of the ApoE4 polymorphism in dementia, both in the Alzheimer's and vascular etiology subgroups. Influence of this polymorphism on various clinical phenotypes, including extent of cognitive and functional deficits, needs further evaluation. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]