Background: Loneliness and depression are the noteworthy mental health issues which are prevalent among older people but only a few studies have addressed this aspect especially in developing countries. So, this study is an attempt to shed light to this aspect of older adult’s life, in order to assess the level of loneliness and depression, to identify associated factors,and to find out the correlation between loneliness and depression.Methods: A descriptive cross-sectional study design was used to collect data from 124 older peopleof age ?60 years living in a community using purposive sampling technique. A structured questionnaire, University of California, Los Angeles scale version 3 loneliness scale, and geriatric depression scale short form (GDS-15) were used to collect data. Mean, Standard deviation, frequency, percentage, chi-square test, and Spearman rank correlation was used to analyze data. Results: Older people felt loneliness either at a moderate level (38.7%) or at a severe level (16.9%). While people with (49.2%) and without depression (50.80%) were in nearly equal proportion. Age,education level, marital status,living arrangement, childlessness, perceived health status, sleep quality, and sleeping hour, and perceived economic satisfaction showed statistically significant association with both dependent variables.While the presence of disease condition was associated with the level of loneliness, the level of depression showed significant statistical association with perceived stress. Further, loneliness and depression seemed to be positively correlated.Conclusions: Older peopleexperiencing loneliness and depression is quite noteworthyand emphasis should be given towards implementation of research approaches to unleash this aspect of older people.Keywords: Community; depression; loneliness; Nepal; older people.

INTRODUCTION

INTRODUCTIONNon communicable diseases (NCDs) are one of the leading causes of mortality and morbidity worldwide afflicting more in developing countries. In 2012, of the total 56 million deaths worldwide, NCD accounted for more than 50% (i.e. 38 million deaths). Of these, more than 70% (28 million deaths) of NCD deaths occurred in low and middle income countries. 1It is interesting to note that, cardiovascular diseases (CVDs) alone lead to 46.2% of NCD deaths followed by cancer, respiratory diseases and diabetes.2 Among cardiovascular diseases, the number of people with hypertension in developed countries is expected to increase by 24% from 333 million to 413 million while in developing countries by 80% from 639 million to 1.15 billion between 2000 and 2025. 3 This data depicts that almost three-quarters of the hypertensive population worldwide will be in developing countries by the year 2025 with the increment of global prevalence of hypertension by 9% in men and 13% in women between 2000 and 2015. 3 In Nepal, the scenario of hypertension is not different from other developing countries. ABSTRACTBackground: Burgeoning burden of non-communicable diseases (especially hypertension) along with communicable diseases has made the situation more worrying in an economically constraint countries like Nepal. Studies are therefore necessary to assess the actual burden of disease; however nominal studies have focused this situation especially in semi urban areas of Nepal. This study was therefore conducted with the main aim of assessing the prevalence of hypertension in suburban area of central Nepal and to find the associated risk factors. Methods: A cross sectional study was conducted in a sub urban area of Changunarayan municipality of Nepal utilizing consecutive convenience sampling method. A total of 240 consenting participants aged ≥18 were enrolled in the study. Data was collected using questionnaire and measurements of blood pressure, waist/hip circumference, height and weight were taken. Chi square test was used to assess the strength of relationship between the categorical variables with p value taken significant at ≤0.05. Only values with significant association were used to obtain the Odds Ratios (OR) via binary logistic regression. Results: The prevalence of hypertension and pre-hypertension was found to be 20.4% and 35.4% respectively. Further, study illustrates the significant association (p≤0.05) of age, gender, family type, presence of co-morbidities, smoking, alcohol intake habits, habit of adding salt, BMI and waist/hip ratio with hypertension. Conclusions: Results of high prevalence of hypertension and its association with several factors indicates the necessity for timely detection, treatment and control of hypertension using various strategies.

Objectives: Maximizing quality of life (QoL) is the ultimate goal of long-term dementia care. However, routine QoL measurement is rare in nursing home (NH) and assisted living (AL) facilities. Routine QoL measurement might lead to improvements in resident QoL. Our objective was to assess the feasibility of using DEMQOL-CH, completed by long-term care staff in video calls with researchers, to assess healthrelated quality of life (HrQoL) of NH and AL residents with dementia or other cognitive impairment. Design: Cross-sectional study. Setting and Participants: We included a convenience sample of 5 NHs and 5 AL facilities in the Canadian province of Alberta. Forty-two care staff who had worked in the facility for !3 months completed DEMQOL-CH assessments of 183 residents who had lived in the facility for 3 months or more and were aged !65 years. Sixteen residents were assessed independently by 2 care staff to assess inter-rater reliability. Methods: We assessed HrQoL in people with dementia or other cognitive impairment using DEMQOL-CH, and assessed time to complete, inter-rater reliability, internal consistency reliability, and care staff ratings of feasibility of completing the DEMQOL-CH. Results: Average time to complete DEMQOL-CH was <5 minutes. Staff characteristics were not associated with time to complete or DEMQOL-CH scores. Inter-rater reliability [0.735, 95% confidence interval (CI): 0.712-0.780] and internal consistency reliability (0.834, 95% CI: 0.779-0.864) were high. The DEMQOL-CH score varied across residents (mean ¼ 84.8, standard deviation ¼ 11.20, 95% CI: 83.2-86.4). Care aides and managers rated use of the DEMQOL-CH as highly feasible, acceptable, and valuable. Conclusions and Implications: This study provides a proof of concept that DEMQOL-CH can be used to assess HrQoL in NH and AL residents and provides initial indications of feasibility and resources required. DEMQOL-CH may be used to support actions to improve the QoL of residents.

IntroductionDementia is a public health issue and a major risk factor for poor quality of life among older adults. In the absence of a cure, enhancing health-related quality of life (HRQoL) of people with dementia is the primary goal of care. Robust measurement of HRQoL is a prerequisite to effective improvement. The DEMQOL suite of instruments is considered among the best available to measure HRQoL in people with dementia; however, no review has systematically and comprehensively examined the use of the DEMQOL in research and summarised evidence to determine its feasibility, acceptability and appropriateness for use in research and practice.Methods and analysisWe will systematically search 12 electronic databases and reference lists of all included studies. We will include systematically conducted reviews, as well as, quantitative and qualitative research studies that report on the development, validation or use in research studies of any of the DEMQOL instruments. Two reviewers will independently screen all studies for eligibility, and assess the quality of each included study using one of four validated checklists appropriate for different study designs. Discrepancies at all stages of the review will be resolved by consensus. We will use descriptive statistics (frequencies, proportions, ranges), content analysis of narrative data and vote counting (for the measures of association) to summarise the data elements. Using narrative synthesis, we will summarise what is known about the development, validation, feasibility, acceptability, appropriateness and use of the DEMQOL. Our review methods will follow the reporting and conduct guidelines of the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis.Ethics and disseminationEthical approval is not required as this project does not involve primary data collection. We will disseminate our findings through peer-reviewed publications and conference presentations.PROSPERO registration numberCRD42020157851.