Depression and Altitude: Cross-Sectional Community-Based Study Among Elderly High-Altitude Residents in the Himalayan Regions
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Suicide rates are higher at high altitudes, and some hypothesize that hypoxia is the cause. There may be a significant correlation between rates of depression and altitude, but little data exist outside the United States. The purpose of the present study is to conduct a survey of depression among the elderly highlanders in Asia. We enrolled 114 persons aged 60 years or older (mean, 69.2 ± 6.7 years; women, 58.8 %) in Domkhar (altitude, 3800 m), Ladakh, India and 173 ethnic Tibetans (mean, 66.5 ± 6.1 years; women, 61.3 %) in Yushu (altitude, 3700 m), Qinghai Province, China. The two-item Patient Health Questionnaire (PHQ-2) and the geriatric depression scale were administered. A psychiatrist interviewed the subjects who had a positive score on the PHQ-2. The results of the interview with the residents conducted by the specialist showed that two cases (1.8 %) from Domkhar and four (2.3 %) from Qinghai had depression. Despite the high altitude, the probability of depression was low in elderly highlander in Ladakh and Qinghai. Our finding seems to indicate that cultural factors such as religious outlook and social/family relationship inhibit the development of depression.
KeywordsDepression Hypoxia High altitude Ladakhi Tibetan
We appreciate all those elderly highlanders in Ladakh and Qinghai who participated in the community-based geriatric examinations. In addition, we would like to express our cordial gratitude to Hongxin Wang, Qingxiang Dai, Airong Yang, Haisheng Qiao, Zhanquan Li, Huining Xu, Haiying Tong, and Ri-Li Ge from Qinghai University Affiliated Hospital and Qinghai Academy Animal and Veterinary Sciences, the staff of the People’s Hospital of Yushu county, and Tsering Norboo, and the staff of Ladakh Institute of Prevention who kindly supported us. This study was mainly supported by a Grant-in-Aid of the Research Institute for Humanity and Nature (3-4 FR): Human Life, Aging, and Disease in High-Altitude Environments: Physio-medical, Ecological and Cultural Adaptation in “Highland Civilizations.” (Leader: Kiyohito Okumiya). This study was funded by a Grant-in-Aid for Scientific Research (C) No. 22590668.
Compliance with Ethical Standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
Human and Animal Rights and Informed Consent
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
- APA (2000). Diagnostic and statistical manual of mental disorders, fourth edition, text revision (DSM-IV-TR). American Psychiatric Association, Washington DC.Google Scholar
- Østbye T, Kristjansson B, Hill G, Newman SC, Brouwer RN, McDowell I (2005) Prevalence and predictors of depression in elderly Canadians: Canadian Study of Health and Aging. Chronic Dis Can 26: 93-99.Google Scholar
- Schory TJ, Piecznski N, Nair S, el-Mallakh RS (2003) Barometric pressure, emergency psychiatric visits, and violent acts. Can J Psychiatry 48: 624-7.Google Scholar
- Sheikh JI, Yesavage JA (1986) Geriatric Depression Scale (GDS). Recent evidence and development of a shorter version. In: Brink TL (ed) Clinical Gerontology: A Guide to Assessment and Intervention. The Haworth Press Inc, New York, pp165-173.Google Scholar
- Unützer J, Katon W, Callahan CM, Williams JW Jr, Hunkeler E, Harpolevv L, Hoffing M, Della Penna RD, Noël PH, Lin EH, Areán PA, Hegel MT, Tang L, Belin TR, Oishi S, Langston C (2002) Collaborative care management of late-life depression in the primary care setting : a randomized controlled trial. JAMA 288: 2836-2845.CrossRefGoogle Scholar
- Watson L, Pignone M (2003) Screening accuracy for late-life depression in primary care: systematic review. J Fam Pract 52: 956-964.Google Scholar
- Weissman MM, Bland RC, Canino GJ, Faravelli C, Greenwald S, Hwu HG, Joyce PR, Karam EG, Lee CK, Lellouch J, Lépine JP, Newman SC, Rubio-Stipec M, Wells JE, Wickramaratne PJ, Wittchen H, Yeh EK (1996) Cross-national epidemiology of major depression and bipolar disorder. JAMA 276:293-299.CrossRefGoogle Scholar