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

Rutgers, The State University of New Jersey, Нью-Брансуик, New Jersey, United States
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.

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Available from: Wenhui Wei
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    • "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. "
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    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.
    Full-text · Article · Apr 2015 · International Psychogeriatrics
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    • "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]). "
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    • "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). "
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