Thursday, January 4, 2024, the Faculty of Public Health (FPH) Universitas Indonesia (UI) held an open session for the Promotion of Doctor of Public Health Sciences (IKM) with promovendus Nia Murniati with a defended dissertation entitled “Biopsychosocial Factors in Elderly Depression in Urban and Rural Indonesia: Study IFLS Data Cohort 2007 and 2014”.
WHO (World Health Organization) predicts that the population aged over 60 years will increase from 12% to 22% as life expectancy increases globally in the period 2015 to 2050. This condition has the consequence that 20% of elderly people (seniors) suffer from disorders. mental and neurological in addition to physical health problems. The national situation reported by Basic Health Research (Riskesdas) 2018 shows that depression can be experienced by all age groups where the prevalence pattern increases with age; The highest was in the elderly group >75 years at 8.9% and in the 65-74 years age group at 8.0% and at 55-64 years at 6.5%.
In Indonesia, the elderly population is not distributed evenly, so that elderly people in urban and rural areas pose a different risk of depression. On the other hand, signs of depression in the elderly are often invisible but can pose a high risk if preventive measures are not taken. The study of depression as a mental health problem must be carried out holistically using the biopsychosocial model, which is widely used in the medical field, especially in the field of psychiatry. In gerontological research, the biopsychosocial model is integrated in several studies to examine mental health problems among the elderly.
Nia Murniati’s research aims to find the relationship between changes in biopsychosocial factors and depression in the elderly in urban and rural areas. Secondary data from the Indonesia Family Life Survey (IFLS) was used through a cohort approach with datasets from 2007 and 2014. The research conceptual framework is a simplification of the biopsychosocial model Laird, 2019; Engel, 1977; Gatchel, 2004; Hancock & Perkins, 1985. The variables involved in the measurement include independent variables, namely changes in biological, psychological, and social factors. Meanwhile, the dependent variable includes changes in the depression status of the elderly in urban and rural Indonesia. The findings reveal risk factors for depression in the elderly in urban and rural areas of Indonesia as material for studying the management of elderly depression problems according to living areas.
Based on the results of his research, it was found that there was a change in the depression status of elderly people by 15.1% in urban areas and 16.2% in rural areas in 2014, whereas at the beginning of observations in 2007 these elderly people did not experience it. Changes in biopsychosocial factors also occurred in both groups of elderly, namely that there was a decrease in biological factors including physical health conditions and physical function which occurred more frequently in urban elderly, while rural elderly experienced a greater decline in psychological factors which included subjective well-being and religiosity. However, changes in social factors, including physical activity, smoking habits, social support, community participation and marital status, occur in various ways in both groups of elderly people, both in urban and rural areas. The findings of these biopsychosocial factors are also conveyed in several variables. Changes in physical health conditions and changes in subjective well-being are variables that are related to elderly people in urban areas, as well as changes in physical health conditions, changes in mutual trust, changes in community participation and changes in marital status (widower) are variables that are related to elderly people in rural areas.
“The proportion of depressed elderly people in urban areas is 15.1% and 16.2% in rural areas. This illustrates that 1 in 7 elderly people in Indonesia experience depression in both urban and rural areas. Epidemiologically, the prevalence of a health problem is said to be large/frequent if the figure is more than 10%. “The rate of depression in the elderly is 15.1% in urban areas and 16.2% in rural areas, showing a prevalence of above 10%, which means it can be said to be a major health problem in Indonesia that requires important attention in prevention efforts,” said Nia in presenting a summary of her dissertation.
The family is the hope in preventing depression in the elderly in rural areas. On the other hand, preventing depression in urban seniors can consider the concept of senior living for seniors who are aware that old age can be better lived in institutions rather than with family, as has been implemented by the DKI Jakarta Provincial Government in the Elderly School community.
Apart from that, Nia advised health workers to persuade family members to pay more attention to the decline in the physical condition of the elderly. Providing education to the elderly and their families through elderly posyandu or activities in associations such as elderly schools, religious communities, where the elderly will receive support from relatives/friends, so that they are more physically and mentally active, thereby having higher life satisfaction, reducing loneliness, and reducing depression.
“Sister has been involved and conducted excellent research at the Faculty of Public Health. “I hope that you will serve better in a vocational program with an atmosphere of logic and application of a doctorate, of course,” said Prof. Dr. Dr. Sudijanto Kamso, S.K.M., in his speech as promoter.
Based on her dissertation, Nia Murniati, who completed her studies for 5 semesters, was declared a graduate and succeeded in obtaining a Doctorate degree in Public Health Sciences (IKM) as the 3rd IKM doctoral graduate of 2024, the 299th IKM doctoral graduate, and a doctoral graduate at FPH UI 385th and received the cum laude predicate.
The session was chaired by Prof. Dr. Dr. Ratna Djuwita, M.P.H., as chair of the session with promoter Prof. Dr. Dr. Sudijanto Kamso, S.K.M., and co-promoter Prof. Dr. Dr. Purwantyastuti, M.Sc., Sp.FK., and Prof. Dr. Dra. Ratu Ayu Dewi Sartika, Apt., M.Sc. The examining team in the trial was Prof. Dr. Ali Nina Liche Seniati, M.Si., Psychologist; Dr. Dr. Herqutanto, M.P.H., MARS.; Dr. Dr. Ria Maria Theresa, Sp. KJ., MH; and Dr. Dr. Fidiansjah, Sp. KJ., M.P.H.