MULTILEVEL ANALYSIS ON

THE CONTEXTUAL EFFECT

OF ELDERLY HEALTH POST
ON THE INCIDENT
OF DEPRESSION AMONG THE
ELDERLY

Christiana Sri Wahyuningsih

Masters Program in Public Health

Universitas Sebelas Maret
 Background

Mental health problems, especially depression, have a major

impact on the elderly. Depression is a major contributor to the
burden of disease globally which can cause suicide.

Suicide is still one of the causes of the high mortality rate in

Gunungkidul, Yogyakarta. The suicide in Gunungkidul was
dominated by the elderly.

Positive social interactions (social support) contribute to the

improvement of a person's psychological and physical well-
being.
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• Social relationships reduce stress and depression, which

can enhance physical health.

• This study aimed to examine the contextual effect of the

elderly health post (“posyandu lansia”) on the incident
of depression among the elderly.
 Subjects and Method

cross sectional study

Gunung Kidul, •
from October to December 2018
Yogyakarta

200 elderly • from 25 elderly health posts was

selected by simple random sampling
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Dependent variable
• depression

Independent variables
• The independent variables of level 1 were income, family type, history
of chronic disease, family function, social interaction, social support,
and loneliness
• The level 2 variable was the elderly health post
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• Data on depression was measured by Geriatric

Depression Scale 15 (GDS-15).

• The other data were collected by questionnaire and

analyzed by a multilevel linear regression.
 Results
The risk of depression among elderly increased with :
• history of chronic disease (b= 0.49; 95% CI= 0.03 to 0.95; p= 0.036)
• social isolation (b= 0.52; 95% CI= 0.01 to 0.49; p= 0.050)
• loneliness (b= 0.30; 95% CI= 0.11 to 0.49; p= 0.002)
The risk of depression among elderly decreased with :
• high income (b= -0.53; 95% CI= -1.03 to -0.03; p= 0.038)
• family type (b= -0.48; 95% CI= -0.95 to -0.02; p= 0.039)
• family function (b= -0.29; 95% CI= -0.48 to -0.10; p= 0.002)
• high social interaction (b= -0.10; 95% CI= 0.19 to 0.01; p= 0.016)
• strong social support (b= -0.07; 95% CI= 0.11 to 0.03; p<0.001).
The elderly health post had negligible contextual effect on depression among elderly (ICC= 6.78%).
 Conclusion

The risk of depression among elderly increases with social

isolation and loneliness. It decreases with high income, family
type, no history of chronic disease, family function, high social
interaction, and strong social support. The elderly health post has
negligible contextual effect on depression among elderly.
Thank You...