What Causes Late-Life Depression? A Qualitative Study of Depressed Iranian Older People

Depression is a major health problem in old age that is closely related to cultural and social contexts. Studies have shown a higher prevalence of geriatric depression in Iran. This qualitative content analysis study aimed to explore the psychosocial factors related to the experience of late life depression in older people in Iran. This qualitative study with a directed content analysis approach was conducted in Tehran in 2015. First, a systematic search in major English and Persian data banks was carried out to develop an analysis matrix. The participants with maximum variations in demographic characteristics were recruited from psychiatric clinics, if they met inclusion criteria, which included: 1) age of 60 years and, and 2) diagnosis above of depression by a psychiatrist in the last six months. Semi-structured interviews were conducted up to reaching data saturation. The interviews were recorded, transcribed verbatim and transformed into meaning units and codes. The codes were then analyzing matrix and reviewed again to form new subcategories and categories. Twelve old people participated in this study. Analyzing the data, 534 codes in 42 subcategories and 17categories led to six main themes which included: 1) transition of value system, 2) role changes, 3) life concerns, 4) inadequacy of social relations, 5) regrets, and 6) impaired health and function. From the perspective of the depressed old people, recent changes in values and impaired social relations, made them feel lonely confronting life struggles and inevitable changes of roles, health status and function. Some context-based interventions such as community alertness and providing more formal support may be helpful in preventing late life depression.