Depression and Its Correlates Among Older Adults Accessing Aging Services

Abstract

Objectives-To define the prevalence and correlates of depression among older adults receiving assessments by nonmedical community-based care managers at the point of entry to care and thus prior to provision of aging services. Our long-term goal is to inform development of collaborative care models for late life depression that incorporate Aging Services Providers. Methods-Aging Services Provider Network (ASPN) clients receiving in-home assessments were administered the Structured Clinical Interview for Diagnostic and Statistical Manual ofMental Disorders, Fourth Edition module for affective disorders and measures of depression symptom severity, alcohol use, physical health, functional status, social support, stressful life events, and religiosity. Engagement in mental healthcare was documented.Results-Subjects (N = 378) were primarily white (84%) and women (69%) with household incomes under $1,750/month (62%). Half lived alone (48%). Their mean age was 77 years. Thirty-one percent had clinically significant depressive symptoms and 27% met criteria for a current major depressive episode, of which 61% were being treated with medication and 25% by a mental health provider. Nearly half (47%) had experienced one or more episodes of major depression during their lives. Disability, number of medical conditions, number and severity of recent stressful life events, low social support, and low religiosity were independently associated with current major depression.Conclusion-Depressive illness was common among this sample of ASPN clients. Because ASPN care managers have expertise in managing many of the problems correlated with depression, they may play a significant role in identifying, preventing, and collaborating in the treatment of depressive illnesses among community-dwelling older adults. KeywordsAged; depression; depressive disorder; depressive disorder; major depressive symptoms; health services for the aged; mental health services; social services; social work; social work; psychiatric NIH Public Access Author ManuscriptAm J Geriatr Psychiatry. Author manuscript; available in PMC 2013 April 1. NIH-PA Author ManuscriptAffective illness is common among older adults and is associated with worse health outcomes, 1 greater healthcare utilization and costs, 2 and increased risk of death from suicide and other causes. 3,4 Improving outcomes of late life depression depends on accurate detection of affected older adults, early intervention, and effective treatment.Because many older adults do not recognize the need for or are reluctant to use mental health care services, emphasis has been placed on primary care as the preferred site for detection and treatment of older patients with affective illness. Yet numerous barriers prevent adequate care for mood disorders in primary care settings, 5,6 including the social morbidities that are so common in this population and with which primary care physicians are typically ill-equipped to deal. In addition to a past history of depression and physical illhealth, disabil...

Visual impairment and depressive symptoms in an older Australian cohort: longitudinal findings from the Blue Mountains Eye Study

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The association between higher social support and lower depressive symptoms among aging services clients is attenuated at higher levels of functional impairment

“…Descriptive data on participants’ characteristics appears in Table 1. Additional descriptive data on this sample has been previously published (O'Riley, et al 2013; Richardson et al 2011a; Richardson et al 2011b; Simning, et al 2010). …”

“…A previous investigation found that 31% of a sample of ASPN clients endorsed clinically significant depressive symptoms on the Patient Health Questionnaire-9 (PHQ-9) and 27% met criteria for a current major depressive episode (Richardson, et al 2011a). Another study found that 10.6% of a sample of ASPN clients met diagnostic criteria for major depressive disorder (Gum, et al 2009).…”

“…In a sample of older adults receiving home delivered meals, 12.2% endorsed clinically significant depressive symptoms on the PHQ-9 (Sirey, et al 2008). ASPN clients experiencing major depressive episodes are likely to also report higher levels of functional impairment, greater numbers of medical conditions and stressful life events, and lower social support than those without depression (Richardson et al 2011a). …”

Gender differences in the roles for social support in ensuring adequate fruit and vegetable consumption among older adult Canadians

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