Aim: Depression is a major disease burden in Thailand. In rural areas, young adults will leave home to work in cities, and older adults are left behind. Loneliness and comorbidities can lead to depression in older adults. The present study aimed to evaluate the prevalence and associated factors for geriatric depression. Methods:A cross-sectional study was carried out. Questionnaires including the Thai Geriatric Depression Scale and family relationship were obtained by healthcare professions by face-to-face interviews of 584 older people aged ≥60 years in Ban Nayao community, Chachoengsao Province, Thailand. Geriatric depression can be defined as depressive syndromes that arise in adults aged ≥60 years. We excluded those who had visual or auditory disabilities or did not pass the Thai Mini-Mental Status Examination. The prevalence and associated factors for geriatric depression were obtained. Associated factors were analyzed by multivariate logistic regression.Results: A total of 433 older people were eligible. The prevalence of geriatric depression was 18.5%. Of the participants, 54.1% lived in an imbalanced family type. Multivariate analysis showed the significance for female sex (adjusted OR 2.78, 95% CI 1.54-7.49, P = 0.01), illiteracy (adjusted OR 2.86, 95% CI 1.19-6.17, P-value 0.04), current smoker (adjusted OR 4.25, 95% CI 2.12-10.18, P = 0.009) and imbalanced family type (low attachment, low cooperation and poor alignment between each member; adjusted OR 4.52, 95% CI 2.14-7.86, P < 0.001) as risk factors for depression. Conclusions:The prevalence of geriatric depression in rural Thailand is high. Imbalanced family type is an important risk factor for geriatric depression in the rural community.

Our study demonstrates a potential association between hypomagnesaemia and depression. Further studies assessing the benefits of treatment of hypomagnesaemia in patients with depression are needed.

BACKGROUNDThe prevalence of older individuals with type 2 diabetes mellitus (T2DM) is increasing due to the aging population and improved medical care. These patients are very susceptible to disease and treatment-related hospitalizations, resulting in higher health care costs, morbidity, and decreased quality of life. However, data of treatment-related complications, especially dysglycemia-related hospitalizations, are lacking.AIMTo assess the prevalence and associated factors for dysglycemia-related hospitalizations among elderly diabetic patients in Thailand using nationwide patient sample.METHODST2DM patients aged ≥ 65 years who received medical care at public hospitals in Thailand in the year 2014 were included. The prevalence of hospitalization due to dysglycemia within one year was examined. Multivariable logistic regression was performed to assess the independent factors associated with hospitalization due to hypoglycemia and hyperglycemiaRESULTSA total of 11404 elderly T2DM patients were enrolled in this study. The mean age was 72.9 ± 5.5 years. The prevalence of hospital admissions due to diabetic ketoacidosis, hyperosmolar hyperglycemic state, hyperglycemic dehydration syndrome, and hypoglycemia among elderly T2DM patients in the year 2014 was 0.1%, 0.1%, 1.7% and 3.1%, respectively. Increased hospitalization due to hypoglycemia was associated with older age, female sex, had hypertension, dementia, lower body mass index, elevated hemoglobin A1C (HbA1C), decreased kidney function, insulin use. Increased hospitalization due to hyperglycemia was associated with dementia, depression, lower body mass index, elevated HbA1C, and insulin use.CONCLUSIONThe prevalence of dysglycemia-related hospitalization in elderly T2DM patients in Thailand was 4.9%. Close monitoring of blood glucose should be provided in high-risk patients for prevention and early detection for these complications.

Background:This study aimed to assess the nationwide trends in optimal diabetic care and complications of elderly type 2 diabetes mellitus (T2DM) patients over a 6-year period in Thailand.Methods: T2DM patients aged 65 years or older who received medical care at public hospitals in Thailand from 2010 to 2015 were included. The optimal T2DM care in elderly patients was defined as (1) blood pressure (BP) < 140/90, (2) hemoglobin A1C (HbA1c) < 7%, (3) low-density lipoprotein cholesterol (LDL-C) < 100 mg/dL, (4) use of antiplatelet medications, and (5) use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) in hypertensive patients. T2DM treatment-related complications included hospital admissions due to dysglycemia.Results: A total of 54 295 elderly T2DM patients were enrolled in this study. From 2010 to 2015, there was an increasing trend in the achievement of BP control and use of antiplatelet medications (P for trend < 0.01), whereas there was a decreasing trend in the achievement of HbA1c and LDL-C control among elderly T2DM patients (P for trend < 0.001). There was an increasing trend in the use of ACEI/ARB among elderly T2DM patients with hypertension (P for trend < 0.001). Hospital admissions due to dysglycemia decreased over the study period (P for trend < 0.001). Conclusion:There has been a trend change for diabetic care among elderly T2DM patients in Thailand. Further studies are needed to assess the impact on patient outcomes. K E Y W O R D Sdiabetes in elderly, diabetic care, diabetic complications, glycemic control, type 2 diabetes mellitus 22wileyonlinelibrary.com/journal/jebm J Evid Based Med. 2019;12:22-28.

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