Psychotherapies for Late-Life Depression

McGovern, Amanda R.; Kiosses, Dimitris N.; Raue, Patrick J.; Wilkins, Victoria M.; Alexopoulos, George S.

doi:10.3928/00485713-20140306-07

Cited by 10 publications

(10 citation statements)

References 29 publications

(28 reference statements)

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“…These may include problem-solving, cognitive and interpersonal psychotherapy, all of which may be helpful in managing late-life depression among older people who are resistant to antidepressant medications. 39 The strengths of this study involve the large number of included studies and the ability to explore sources of heterogeneity. On the other hand, the limitation of the available literature and consequently of this review is the relative paucity of studies that used physician diagnoses to assess depression.…”

Section: Discussionmentioning

confidence: 99%

The association of late-life depression with all-cause and cardiovascular mortality among community-dwelling older adults: systematic review and meta-analysis

et al. 2019

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BackgroundLate-life depression has become an important public health problem. Available evidence suggests that late-life depression is associated with all-cause and cardiovascular mortality among older adults living in the community, although the associations have not been comprehensively reviewed and quantified.AimTo estimate the pooled association of late-life depression with all-cause and cardiovascular mortality among community-dwelling older adults.MethodWe conducted a systematic review and meta-analysis of prospective cohort studies that examine the associations of late-life depression with all-cause and cardiovascular mortality in community settings.ResultsA total of 61 prospective cohort studies from 53 cohorts with 198 589 participants were included in the systematic review and meta-analysis. A total of 49 cohorts reported all-cause mortality and 15 cohorts reported cardiovascular mortality. Late-life depression was associated with increased risk of all-cause (risk ratio 1.34; 95% CI 1.27, 1.42) and cardiovascular mortality (risk ratio 1.31; 95% CI 1.20, 1.43). There was heterogeneity in results across studies and the magnitude of associations differed by age, gender, study location, follow-up duration and methods used to assess depression. The associations existed in different subgroups by age, gender, regions of studies, follow-up periods and assessment methods of late-life depression.ConclusionLate-life depression is associated with higher risk of both all-cause and cardiovascular mortality among community-dwelling elderly people. Future studies need to test the effectiveness of preventing depression among older adults as a way of reducing mortality in this population. Optimal treatment of late-life depression and its impact on mortality require further investigation.Declaration of interestNone.

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Section: Discussionmentioning

confidence: 99%

The association of late-life depression with all-cause and cardiovascular mortality among community-dwelling older adults: systematic review and meta-analysis

et al. 2019

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“…Facing the challenge of an ageing society and a rising number of geriatric patients in the future, adequate treatment options are required. Although antidepressant use especially in the elderly has increased (Olfson & Marcus, 2009), only one-third of older patients achieve remission (McGovern et al 2014). Pharmacotherapy with antidepressants in older persons is also associated with higher all-cause mortality (Coupland et al 2011).…”

Section: Discussionmentioning

confidence: 99%

Approval of psychotherapy and medication for the treatment of mental disorders over the lifespan. An age period cohort analysis

Auwera

Schomerus

Baumeister

et al. 2016

Epidemiol Psychiatr Sci

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Underutilisation of psychotherapy in old age seems not to reflect treatment preferences of older persons. Thus, special treatment approaches need to be offered for this group that seems to be willing for psychotherapy but do not yet use it. Cohort patterns suggest that approval of psychotherapy among older persons will likely further increase in the coming years as these people get older. Finally, strong period effects underpin the importance of changing attitudes in the society. These could reflect reporting changes about psychiatric topics in the media or a general increase in the perception of treatment options. Nevertheless, more treatment offers especially for older people are needed.

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“…Meta-analyses and systematic reviews have provided extensive evidence that psychotherapeutic interventions are effective for treating depression in the older population, with strongest evidence for cognitive and behavioral therapy (CBT), life review therapy (LR) and problem-solving therapy (PST) [8,9]. However, vulnerable older adults with depression including very old, frail and care-dependent older adults were mostly excluded from these studies [10], despite advances for psychotherapeutic research in the context of specific comorbid conditions including chronic obstructive pulmonary disease (COPD), heart failure, Parkinson's disease, stroke, early stages of dementia and suicidal ideations [for an overview, see [11]].…”

Section: Introductionmentioning

confidence: 99%

Outpatient psychotherapy for home-living vulnerable older adults with depression: study protocol of the PSY-CARE trial

et al. 2020

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Background: There is a need to improve psychotherapeutic approaches to treatment for vulnerable older adults with depression in terms of both clinical practice and health care supply. Against this background, PSY-CARE is testing the feasibility and effectiveness of outpatient psychotherapy for home-living older adults in need of care with depression in Berlin, Germany, and neighboring suburban areas. Methods: In a two-arm single-center pragmatic randomized controlled trial (RCT), manual-guided outpatient psychotherapy will be compared to brief psychosocial counseling. The study population will be compromised of older adults with clinically significant depressive symptoms who have a long-term care grade, as assessed by the German compulsory state nursing care insurance. In the intervention group, individual cognitive-behavioral psychotherapy tailored to the specific needs of this population will be offered by residential psychotherapists as part of the regular healthcare service. In the active control group, participants will receive individual psychosocial telephone counselling and a self-help guide. The planned sample size is N = 130 (n = 65 participants per group). The reduction of depressive symptoms (primary outcome) as well as the maintaining of activities of daily living, quality of life, and functioning will be assessed with questionnaires provided at baseline, after the end of the intervention and after three months. Feasibility and process evaluation will be conducted qualitatively based on documentation and interviews with psychotherapists, gatekeepers and the participants. Discussion: PSY-CARE investigates the potentials and limitations of providing outpatient psychotherapeutic treatment meeting the demands of vulnerable home-living older adults with depression under the real conditions of the health care system. The study will provide practical implications to improve access to and quality of outpatient psychotherapy for this poorly supplied population.

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Psychotherapies for Late-Life Depression

Cited by 10 publications

References 29 publications

The association of late-life depression with all-cause and cardiovascular mortality among community-dwelling older adults: systematic review and meta-analysis

The association of late-life depression with all-cause and cardiovascular mortality among community-dwelling older adults: systematic review and meta-analysis

Approval of psychotherapy and medication for the treatment of mental disorders over the lifespan. An age period cohort analysis

Outpatient psychotherapy for home-living vulnerable older adults with depression: study protocol of the PSY-CARE trial

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