Prevalence of Psychiatric Morbidity and Pathways to Care Among the Geriatric Population in North-East, India

This cross-sectional stucjy, involving 1993 adults (873 males and 1120 females) aged 60 and older residing in rural areas in the Sonitpur district of Assam, India, aimed to investigate the prevalence of psychiatric morbidity and the pathways to care, which refers to the speciflc steps and methods individuals take to seek mental health treatment. Data were gathered using socio-demographic and clinical data sheets, semi-structured interviews, the Mini-Mental State Examination (MMSE), and the Cambridge Examination for Mental Disorders of the elderly - Revised (CAMDEX-R). The prevalence of cognitive impairment was notable: 35 per cent had mild cognitive impairment, 30.7 per cent moderate, and 1 per cent severe. Significant gender differences in cognitive impairment were observed (Chi-square = 108.59, df = 3, P < 0.001). Personality changes were reported in 1.5 per cent of cases. Common challenges included difficulties with recent memory, interpreting surroundings, and managing daily tasks. Depression was reported in 24 per cent of participants, with 5.6 per cent feeling depressed and 0.7 per cent experiencing severe depression. Minor issues with perceptual disturbances and strokes were noted. Attribution of illness varied, with 21.4 per cent attributing it to old age and 0.6 per cent to supernatural causes. Sixty-six per cent sought treatment, primarily from psychiatrists (55.4%) and physicians (39.7%). The study highlights a significant prevalence of psychiatric morbidity, including depression and cognitive impairment, and the need for specialised mental health services in rural Assam. It underscores the importance of targeted interventions, increased community awareness, and comprehensive training for healthcare professionals to address the complex needs of the elderly.