• depression;
  • physical disorders;
  • disability;
  • elderly;
  • Nigerians

OBJECTIVES: To compare the effects of depression and chronic physical conditions on disability in elderly persons.

SETTING: Yoruba-speaking areas of Nigeria.

DESIGN: Interviews.

PATICIPANTS: Community-dwelling persons aged 65 and older.

METHOD: Face-to-face interviews were conducted with a representative sample of community-dwelling persons aged 65 and older (N=2,152) in the Yoruba-speaking areas of Nigeria (representing ∼22% of the national population). Major depressive disorder (MDD) was assessed using the World Health Organization Composite International Diagnostic Interview. Chronic pain and medical disorders were assessed using self-report. Disorder-specific disability was evaluated using the Sheehan Disability Scale (SDS).

RESULTS: MDD was highly comorbid with each of the medical conditions (odds ratio range 1.3–2.0). A higher proportion of persons with MDD (47.2%) were rated severely disabled globally than those with arthritis (20.6%), chronic spinal pain (24.2%), or high blood pressure (25.0%). Subjects with MDD were also more likely to be severely disabled in three of the four domains of the SDS. In pair-wise comparisons, persons with MDD had significantly higher levels of disability than those with any of the disorders, with differences in mean scores ranging between −3.74 and −27.50.

CONCLUSION: To reduce the public health burden of depression, its prevention and treatment require more clinical and research attention than currently given by developing countries.