title: Depression and Altitude: Cross-Sectional Community-Based Study Among Elderly High-Altitude Residents in the Himalayan Regions.
abstract: 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.
authors.affiliation: Department of Medicine, Medical Center East, Tokyo Women's Medical University, Nishiogu, 2-1-10 Arakawa, Tokyo, 116-8567, Japan. mishikawa-tky@umin.ac.jp.
authors.forename: Motonao
authors.initials: M
authors.lastname: Ishikawa
authors.affiliation: Department of Medicine, Medical Center East, Tokyo Women's Medical University, Nishiogu, 2-1-10 Arakawa, Tokyo, 116-8567, Japan.
authors.forename: Gaku
authors.initials: G
authors.lastname: Yamanaka
authors.affiliation: Department of Internal Medicine, Aino Hospital, Osaka, Japan.
authors.forename: Naomune
authors.initials: N
authors.lastname: Yamamoto
authors.affiliation: Department of Medicine, Medical Center East, Tokyo Women's Medical University, Nishiogu, 2-1-10 Arakawa, Tokyo, 116-8567, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakaoka
authors.affiliation: Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan.
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Okumiya
authors.affiliation: Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan.
authors.forename: Kozo
authors.initials: K
authors.lastname: Matsubayashi
authors.affiliation: Department of Medicine, Medical Center East, Tokyo Women's Medical University, Nishiogu, 2-1-10 Arakawa, Tokyo, 116-8567, Japan.
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Otsuka
authors.affiliation: Department of Medicine, Medical Center East, Tokyo Women's Medical University, Nishiogu, 2-1-10 Arakawa, Tokyo, 116-8567, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sakura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000531:Altitude; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000523:psychology*; D007194:India / Q000453:epidemiology; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012111:Residence Characteristics; D011795:Surveys and Questionnaires
keywords: Depression; High altitude; Hypoxia; Ladakhi; Tibetan