Depression and Its Correlates Among Older Adults Accessing Aging Services

• Published in: The American journal of geriatric psychiatry 2012-04, Vol.20 (4), p.346-354
• Main Authors: Richardson, Thomas M., Ph.D., M.B.A, Friedman, Bruce, Ph.D, Podgorski, Carol, Ph.D, Knox, Kerry, Ph.D, Fisher, Susan, Ph.D, He, Hua, Ph.D, Conwell, Yeates, M.D
• Format: Article
• Language: English
• Subjects: Aged; depression; Depression - diagnosis; Depression - epidemiology; Depression - psychology; Depressive Disorder, Major - epidemiology; depressive symptoms; Female; health services for the aged; Health Services for the Aged - utilization; Humans; Internal Medicine; Life Change Events; major affective disorder; Male; mental health services; Mental Health Services - utilization; New York - epidemiology; Patient Acceptance of Health Care - psychology; Prevalence; Religion; Risk Factors; social services; Social Support; social work
• ISSN: 1064-7481; 1545-7214
• DOI: 10.1097/JGP.0b013e3182107e50

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 DSM-IV-TR (SCID) 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.