Abstract:Background: There is long-standing concern regarding poor recognition of depression in primary care, especially in older people. Methods: Studies that examined the unassisted (clinical) ability of general practitioners (GPs; primary care physicians) to identify depression were divided into those of older adults, younger adults and mixed populations. Data were extracted by 3 reviewers independently and pooled using a Bayesian meta-analysis. Results: We identified 31 valid studies that examined both sensitivity … Show more
“…35 Approximately 66% of depression is underdiagnosed in primary care settings while a meta-analysis stratified on age found that general practitioners were only able to correctly identify 47% of late life depression cases. 36,37 Removing the barriers to diagnosis and management of depression in clinical practice is important to the care of older adults.…”
Purpose-On the basis of several small studies, depression is often considered a barrier to CR enrollment and program completion. The purpose of this research was to examine the association between depression diagnosis and participation in CR in a large sample of Medicare beneficiaries with recent myocardial infarction (MI).Methods-This was a retrospective study of Medicare Beneficiaries with an MI during 2008 (n=158,991). CR enrollment was determined by the Carrier and Outpatient files using the Healthcare Common Procedure Coding System #93797 or #93798. Depression diagnosis was obtained from the ICD-9 codes in the MEDPAR, Outpatient, and Carrier Files. The association between depression diagnosis and CR attendance was evaluated using multivariable logistic regression.
HHS Public AccessAuthor manuscript J Cardiopulm Rehabil Prev. Author manuscript; available in PMC 2018 January 01.
Author Manuscript Author ManuscriptAuthor Manuscript
Author ManuscriptResults-Overall, 14% (n=22,735) of the study population attended CR within 1 year of MI diagnosis. Twenty-eight percent (n=43,827) had a diagnosis of depression with 96% of cases documented prior to enrollment in CR. Twenty-eight percent with a diagnosis of depression compared to 9% without depression attended CR. In adjusted analysis, patients with depression were 3.9 (99% confidence interval: 3.7, 4.2) times more likely to attend CR compared to those without depression. Program completion (≥ 25 sessions) was more common in those with depression (56%) than those without (35%; p < 0.001).
“…35 Approximately 66% of depression is underdiagnosed in primary care settings while a meta-analysis stratified on age found that general practitioners were only able to correctly identify 47% of late life depression cases. 36,37 Removing the barriers to diagnosis and management of depression in clinical practice is important to the care of older adults.…”
Purpose-On the basis of several small studies, depression is often considered a barrier to CR enrollment and program completion. The purpose of this research was to examine the association between depression diagnosis and participation in CR in a large sample of Medicare beneficiaries with recent myocardial infarction (MI).Methods-This was a retrospective study of Medicare Beneficiaries with an MI during 2008 (n=158,991). CR enrollment was determined by the Carrier and Outpatient files using the Healthcare Common Procedure Coding System #93797 or #93798. Depression diagnosis was obtained from the ICD-9 codes in the MEDPAR, Outpatient, and Carrier Files. The association between depression diagnosis and CR attendance was evaluated using multivariable logistic regression.
HHS Public AccessAuthor manuscript J Cardiopulm Rehabil Prev. Author manuscript; available in PMC 2018 January 01.
Author Manuscript Author ManuscriptAuthor Manuscript
Author ManuscriptResults-Overall, 14% (n=22,735) of the study population attended CR within 1 year of MI diagnosis. Twenty-eight percent (n=43,827) had a diagnosis of depression with 96% of cases documented prior to enrollment in CR. Twenty-eight percent with a diagnosis of depression compared to 9% without depression attended CR. In adjusted analysis, patients with depression were 3.9 (99% confidence interval: 3.7, 4.2) times more likely to attend CR compared to those without depression. Program completion (≥ 25 sessions) was more common in those with depression (56%) than those without (35%; p < 0.001).
“…However, general practitioners might lack the time and the training to properly identify and address mental health problems, especially in older adults (Mitchell, Rao, & Vaze, 2010), as well as normalising the occurrence of certain conditions, such as depression (Burroughs et al, 2006). The high prevalence of physical chronic conditions in this age group might also deter the clinician of focusing on psychological problems.…”
“…Approximately 10% to 15% of the older population suffers from some form of depressive complaint (Kraaij, 2001). Based on a recent meta analysis (Mitchell, Rao, & Vaze, 2010), the point prevalence of depression in older adults was estimated at 13.2%. Because ageing is accompanied by an objective increase in negative life events, for example personal loss and physical deterioration (e.g.…”
Section: Subjective Well-being In Later Lifementioning
Time perspective is crucial for our present and future plans, and for the way we act in the present. The aim of this study was to investigate the relationship between time perspective and subjective well-being in older adults. The sample of our questionnaire study consisted of 149 older adults aged between 65 and 96 years. Time perspective was measured with the Zimbardo Time Perspective Inventory. The five time perspective dimensions were related to four specific aspects of subjective well-being (positive affect, negative affect, life satisfaction and depression). Future-oriented older persons had a more positive affect. Older adults who were positively oriented towards the past appeared to be more satisfied with life. A hedonistic view of the present was related to a high positive affect. Older persons with a Past-Negative perspective were more likely to experience negative affect and depressive feelings, along with a lower level of positive affect and satisfaction with life. The Present-Fatalistic time perspective correlated with more depressive symptoms. The findings emphasize the relevance of time perspective styles for the subjective well-being, which has specific implications for the way caregivers could interact with older adults to enhance quality of life.
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