Prevalence and Associated Factors of Cognitive Impairment, Depression, and Disability among Older Adults with Chronic Illnesses in Batticaloa, Sri Lanka: A Cross-sectional Study

Abstract

Older adults with chronic illnesses are at high risk of developing depression, cognitive impairment, and disability. However, limited research has examined the interrelationships between these conditions in post-conflict regions such as Batticaloa, Sri Lanka. This study aimed to assess prevalence and associated factors of depression, cognitive impairment, and disability among older adults with chronic illnesses in Batticaloa, Sri Lanka. A descriptive cross-sectional study was conducted among 427 older adults (≥60 years) with chronic illnesses attending follow-up clinics at Batticaloa Teaching Hospital. Validated assessment tools were used, including the Geriatric Depression Scale, the World Health Organization Disability Assessment Schedule 2.0, and the Montreal Cognitive Assessment. Descriptive statistics were used to summarise the data. Pearson’s correlation was applied to assess the associations between depression, cognitive impairment, and disability. Depression was prevalent in 69% of participants, with 22% experiencing severe symptoms. Cognitive impairment and disability were observed in 68% and 86% of participants, respectively. Depression was significantly correlated with disability (r=0.418, p<0.001), while cognitive impairment was negatively correlated with both depression (r=-0.216, p<0.001) and disability (r=-0.305, p<0.001). This study found that depression, cognitive impairment, and disability are highly prevalent among older adults with chronic illnesses in Batticaloa, Sri Lanka. Depression was closely linked to higher levels of disability, while cognitive impairment showed weaker associations with both conditions. The findings point to an urgent need for comprehensive geriatric assessments, community-based rehabilitation programs, and caregiver support mechanisms in Sri Lanka and similar settings.