Prevalence of physical comorbidity and prescription patterns in elderly patients with depression: A multicentric study under the aegis of IAGMH

Aim of the Study: This study aims to evaluate the prevalence of physical comorbidities and prescription patterns in elderly patients with depression. Materials and Methods: This study included 488 elderly patients (aged ≥60 years) with depression recruited across eight centers. A self-designed physical comorbidity checklist was used to assess for the presence of various physical comorbidities and prescription of psychotropic medications was recorded. Results: More than three-fourth of the study sample (n = 384; 78.7%) had at least one physical comorbidities and one-third (36.7%) of the samples had at least three physical illnesses. About half of the study samples had hypertension (47.3%) and slightly more than one-fourth had diabetes mellitus (29%). The most common physical illness involved the cardiovascular system (51.5%), followed by endocrinological system (39.3%), orthopedic and joint-related diseases (35%), and ophthalmological problems (22.3%). Those with physical comorbidity had higher severity of depression, anxiety, and somatic symptom. Sertraline was the most preferred antidepressant followed by escitalopram and mirtazapine. Only 12.7% of the sample was prescribed antipsychotics of which quetiapine and olanzapine were the most commonly used agents. Benzodiazepines were prescribed to more than half of the study samples (56.55%), with clonazepam being the most preferred benzodiazepine followed by lorazepam. Compared to those without hypertension, those with hypertension were more commonly prescribed sertraline and escitalopram and less commonly prescribed fluoxetine. Similarly, compared to those without diabetes mellitus, those with diabetes mellitus were more commonly prescribed sertraline and less commonly prescribed fluoxetine. Conclusion: Comorbid physical illnesses are highly prevalent in elderly participants with depression with hypertension being the most common physical comorbidity followed by diabetes mellitus and osteoarthritis. The presence of physical comorbidity is associated with more frequent prescription of sertraline and escitalopram.