Prevalence and covariates of depression among older adults in Nepal: A systematic review and meta-analysis.

Globally, depression is the most common mental health condition in older individuals which is a significant emerging public health problem in developing countries like Nepal. Older adults with depression are overlooked in Nepal due to the paucity of updated evidences on geriatric depression. The current study is aimed to determine the prevalence of depression and its covariates among older adults. PRISMA-compliant searches of the PubMed, Scopus, NepMed/Nepjol, and Google Scholar databases were conducted from 2013 to 2023. The included papers' quality was assessed using a JBI quality appraisal technique. The data were analysed using R statistical program. Heterogenicity was assessed by I2 test. Random-effects model was used to calculate the pooled prevalence of depression. Twenty studies from three regions of Nepal including 5728 older adults were assessed. In Nepal, geriatric depression affected 52% of the overall population (95% CI = 44%, 59%). The pooled prevalence in the subgroup analysis was higher in the central region and among older adults living in old age homes. The presence of chronic diseases, ≥ 70 years of age, female, illiterate, limitation of Instrumental activities of daily living (IADL), and feeling of loneliness were the independent predictors of geriatric depression. Egger (p < 0.0002) and Harbord (p< 0.0001) indicated the presence of publication bias. Even though the estimation of depression differs with geographic region and study settings, one out of two older adults in Nepal had depression, suggesting the need for public health interventions to support and reduce geriatric depression in Nepal.