Prevalence and Treatment of Diagnosed Depression among Elderly Nursing Home Residents in Ohio

Foundation for Informed Medical Decision Making, Boston, MA 02108, USA.
Journal of the American Medical Directors Association (Impact Factor: 4.94). 12/2007; 8(9):585-94. DOI: 10.1016/j.jamda.2007.07.010
Source: PubMed


To examine the prevalence and treatment of diagnosed depression among elderly nursing home residents and determine the resident and facility characteristics associated with diagnosis and treatment.
Documented depression, pharmacotherapy, psychotherapy, sociodemographics, and medical characteristics were obtained from Ohio's Minimum Data Set for 76 735 residents in 921 nursing homes. The data were merged with Online Survey Certification and Reporting System data to study the impact of facility characteristics. Chi-squared statistics were used to test group differences in depression diagnosis and treatment. Multiple logistic regressions were used to examine the prevalence of diagnosed depression, and among those diagnosed, of receiving any treatment.
There were 48% of residents who had an active depression diagnosis; among those diagnosed, 23% received no treatment; 74% received antidepressants; 0.5% received psychotherapy; and 2% received both. African Americans, the severely cognitively impaired, and those in government facilities were less likely to be diagnosed. Residents aged 85 and older, African Americans, individuals with severe mental illness, those with severe ADL or cognitive impairment, and individuals living in a facility with 4 or more deficiencies were less likely to receive treatment.
Significant disparities exist both in diagnosis and treatment of depression among elderly residents. Disadvantaged groups such as African Americans and residents with physical and cognitive impairments are less likely to be diagnosed and treated. Our results indicate that work needs to be done in the nursing home environment to improve the quality of depression care for all residents.

Download full-text


Available from: Wenhui Wei, Oct 09, 2015
23 Reads
  • Source
    • "Depression rates in older adults who reside in nursing homes without cognitive impairment are significantly higher compared to those among older adults in the community and vary from 24% to 82% (Drageset et al., 2011). Significant health disparities exist for cognitively impaired older adults, as they are less likely to be diagnosed and treated for depression than older adults with normal cognitive functioning (Levin et al., 2007). A variety of treatments exist for both anxiety and depression in older adults with mild dementia. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Treatment of anxiety and depression, the most common psychiatric symptoms in older adults with mild dementia, requires innovative approaches due to the high cost and significant side effects associated with traditional pharmacological interventions. Alternative non-pharmacological therapies, such as music, when used in conjunction with pharmacological treatment, have the potential to alleviate symptoms of anxiety and depression in older adults diagnosed with mild dementia. The purpose of this review was to examine the evidence of music's efficacy in improving symptoms of anxiety and depression in older adults with mild dementia. Methods: Four databases (Medline, CINAHL, PsychInfo, PubMed) were searched using the terms “music,” “music therapy,” “music intervention,” “singing,” “dementia,” “anxiety,” and/or “depression,” identifying ten studies that met the inclusion and exclusion criteria. Results: The poor methodological rigor of the studies precluded reaching consensus on the efficacy of a music intervention in alleviating symptoms of anxiety and depression in older adults with mild dementia. Conclusions: There was inconclusive evidence as to whether music interventions are effective in alleviating symptoms of anxiety and depression in older adults with mild dementia due to the poor methodological rigor. However, with improved designs guided by a deeper understanding of how music engages the aging brain, music may emerge as an important adjunct therapy to improving the lives of older adults with mild dementia.
    International Psychogeriatrics 04/2015; 27(10):1-10. DOI:10.1017/S1041610215000393 · 1.93 Impact Factor
  • Source
    • "Recognition rates of depression in older persons have typically been reported to be low [13] although more recent research indicates that the situation may be improving [14]. Recognition in this age group is particularly difficult because of the overlap of symptoms between depression and physical health problems [15,16] and between depression and dementia [17,18]). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Those working with elderly care recipients require a good working knowledge of depression and appropriate help giving responses. While it is important for age-care staff to recognize depression in care recipients it is also critical that they know the appropriate course of action to assist a care recipient who may be depressed. This study aims to determine the knowledge of age-care staff of appropriate help giving responses, their confidence in knowing what kind of assistance to provide and their actual likelihood of providing help to potentially depressed care recipients and to examine if these measures improve following an intervention training program. Methods One hundred and two age-care staff were surveyed on their confidence in helping age-care recipients and on their knowledge of appropriate ways to provide assistance. Staff then participated in a two hour depression awareness raising intervention. The survey was repeated immediately following the training and again six months later. Results Staff confidence in knowing how to provide assistance increased significantly subsequent to training and remained significantly improved at the six month follow up. In addition, a significantly higher proportion of staff reported helping care recipients at the six month follow up. Conclusions This study highlights the potential of a brief staff training program to provide a cost effective means to improve staff self-confidence and increase the likelihood of staff providing assistance to depressed care recipients.
    BMC Nursing 04/2013; 12(1):10. DOI:10.1186/1472-6955-12-10
  • Source
    • "Thus, the need for behavioral clinicians and researchers to address problems such as LLD is likely to increase considerably. Clinically significant depressive symptoms have been found to occur in approximately 8% to 16% of community-dwelling older adults (Blazer, 2003) and in nearly 50% of long-term care residents (Levin et al., 2007); however, these estimates may be low. Depression is likely to be underdiagnosed in older individuals because it is often comorbid with medical illness, and may be compounded by neurological and functional impairment (Fiske et al., 2009; Wilkins, Mathews, & Sheline, 2009). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Late-life depression (LLD) is a major public health concern that can have devastating effects on older individuals and their families. Behavioral theories predict that decreases in response contingent positive reinforcement and increases in negatively reinforced avoidance behaviors, often accompanied by aversive life events, result in the selection and maintenance of depression. Based on these theories, behavioral activation treatments for depression are designed to facilitate structured increases in enjoyable activities that increase opportunities for contact with positive reinforcement. We discuss the applicability of behavioral models for LLD, and we briefly review current behavioral activation interventions for LLD with an emphasis on implications for future behavior-analytic research. Behavioral activation has been demonstrated to be effective in reducing depression and increasing healthy behavior in older adults. Potential challenges and considerations for future research are discussed. We suggest that applied behavior analysts and clinical behavior analysts are particularly well suited to expand on the knowledge base and practical application of behavioral activation interventions with this population.
    The Behavior analyst / MABA 03/2013; 36(1):33-53. · 1.08 Impact Factor
Show more