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Current Geriatrics Reports

Erschienen in:

01.03.2013 | Interdisciplinary Studies in Geriatric Mental Health (DJ Kayman, Section Editor)

Depression in Homebound Older Adults: Recent Advances in Screening and Psychosocial Interventions

verfasst von: Namkee G. Choi, Jo Anne Sirey, Martha L. Bruce

Erschienen in: Current Geriatrics Reports | Ausgabe 1/2013

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Abstract

Homebound older adults are more likely than their ambulatory peers to suffer from depression. Unfortunately, the effectiveness of antidepressant medications alone in such cases is limited. Greater benefits might be realized if patients received both pharmacotherapy and psychotherapy to enhance their skills to cope with their multiple chronic medical conditions, isolation, and mobility impairment; however, referrals to specialty mental health services seldom succeed due to inaccessibility, shortage of geriatric mental health providers, and cost. Since a large proportion of homebound older adults receive case management and other services from aging services network agencies, the integration of mental health services into these agencies is likely to be cost-efficient and effective. This review summarizes recent advances in home-based assessment and psychosocial treatment of depression in homebound recipients of aging services.

He W, Sengupta M, Veikoff VA, DeBarros KA. 65+ in the United States: 2005. U.S. Census Bureau, Current Population Reports, P23-209. Washington, D.C: U.S. Government Printing Office; 2005.

Jacobs JM, Maaravi Y, Cohen A, et al. Changing profile of health and function from age 70 to 85 years. Gerontol. 2012;58:312–21.CrossRef

United States Census Bureau. Table 35. Persons 65 Years and Over—Living Arrangements and Disability Status, 2009. Statistical Table Based on data from the 2009 American Community Survey. Available at http://www.census.gov/compendia/statab/2012/tables/12s0035.pdf. Accessed October 2012.

Centers for Medicare and Medicaid Services. Medicare and Medicaid Supplemental Statistics, 2011. Tables 7.2 Persons Served, Visits, Total Charges, Visit Charges, and Program Payments for Medicare Home Health Agency Services: Calendar Year 2010; and Table 6.2 Covered Admissions, Covered Days of care, Covered Charges, and Program Payments for Skilled Nursing Facilities Used by Medicare Beneficiaries: Calendar Year 2010. Available at http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/MedicareMedicaidStatSupp/2011.html. Accessed October 2012.

Wiles JL, Leibing A, Guberman N, et al. The meaning of "aging in place" to older people. Gerontologist. 2012;52:357–66.PubMedCrossRef

Bruce ML, McVay J, Raue PJ, et al. Major depression in elderly home health care patients. Am J Psychiatry. 2002;159:1367–74.PubMedCrossRef

Choi NG, Teeters M, Perez L, et al. Severity and correlates of depressive symptoms among recipients of Meals in Wheels: Age, gender, and racial/ethnic difference. Aging Ment Health. 2010;14:145–54.PubMedCrossRef

Cohen-Mansfield J, Shmotkin D, Hazan H. The effect of homebound status on older adults. J Am Geriatr Soc. 2010;58:2358–62.PubMedCrossRef

Ell K, Unützer J, Aranda M, et al. Routine PHQ-9 depression screening in home health care: Depression prevalence, clinical and treatment characteristics, and screening implementation. Home Health Care Serv Q. 2005;24:1–19.PubMedCrossRef

10.

Sirey JA, Bruce ML, Carpenter M, et al. Depressive symptoms and suicidal ideation among older adults receiving home-delivered meals. Int J Geriatr Psychiatry. 2008;23:1306–11.PubMedCrossRef

11.

Raue PJ, Meyers BS, Rowe JL, et al. Suicidal ideation among elderly homecare patients. Int J Geriatr Psychiatry. 2007;22:32–7.PubMedCrossRef

12.

Rowe JL, Conwell Y, Schulberg HC, Bruce ML. Social support and suicidal ideation in older adults utilizing home healthcare services. Am J Geriatr Psychiatry. 2006;14:758–66.PubMedCrossRef

13.

Weinberger ML, Raue PJ, Meyers BS, Bruce ML. Predictors of new onset depression in medically ill, disabled older adults at 1 year follow-up. Am J Geriatr Psychiatry. 2009;17:802–9.PubMedCrossRef

14.

Johnson CM, Sharkey JR, Dean WR. Indicators of material hardship and depressive symptoms among homebound older adults living in North Carolina. J Nutrition Grontol Geriatr. 2011;30:154–68.CrossRef

15.

Lyness JM, Kim J, Tang W, et al. The clinical significance of subsyndromal depression in older primary care patients. Am J Geriatr Psychiatry. 2007;15:214–23.PubMedCrossRef

16.

Lyness JM. Naturalistic outcomes of minor and subsyndromal depression in older primary care patients. Int J Geriatr Psychiatry. 2008;23:773–81.PubMedCrossRef

17.

Cui X, Lyness JM, Tang W, et al. Outcomes and predictors of late-life depression trajectories in older primary care patients. Am J Geriatr Psychiatry. 2008;16:406–15.PubMed

18.

Lyness JM, Chappman BP, McGriff J, et al. One-year outcomes of minor and subsyndromal depression in older primary care patients. Int Psychogeriatr. 2009;21:60–8.PubMedCrossRef

19.

Katon WJ, Lin E, Russo J, et al. Increased medical care costs of a population-based sample of depressed elderly patients. Arch Gen Psychiatry. 2003;60:897–903.PubMedCrossRef

20.

Unutzer J, Schoenbaum M, Katon WJ, et al. Healthcare costs associated with depression in medically ill fee-for-service Medicare participants. J Am Geriatr Soc. 2009;57:506–10.PubMedCrossRef

21.

Akincigil A, Olfson M, Walkup JT, et al. Diagnosis and treatment of depression in older community-dwelling adults: 1992–2005. J Am Geriatr Soc. 2011;59:1042–51.PubMedCrossRef

22.

Weissman J, Meyers BS, Ghosh S, Bruce ML. Demographic, Clinical and Functional Factors Associated with Antidepressant Use in the Home healthcare Elderly. Am J Geriatr Psychiatry. 2011;19:1042–5.PubMedCrossRef

23.

Choi NG, Bruce ML, Marinucci ML, et al. Self-reported antidepressant use among depressed, low-income homebound older adults: Class, type, correlates, and perceived effectiveness. Brain Behav. 2012;2:176–86.CrossRef

24.

Kales HC, Nease DE Jr, Sirey JA, et al. racial differences in adherence to antidepressant treatment in late life. Am J Geriatr Psychiatry. 2012, Oct 10. Epub ahead of print. PMID: 23060311.

25.

Maust DT, Oslin DW, Thase ME. Going Beyond Antidepressant Monotherapy for Incomplete Response in Nonpsychotic Late-Life Depression: A Critical Review. Am J Geriatr Psychiatry. 2012, Oct 5. Epub ahead of print. PMID: 23044641.

26.

Gum AM, Areán PA, Hunkeler E, et al. Depression treatment preferences in older primary care patients. Gerontologist. 2006;46:14–22.PubMedCrossRef

27.

Choi N, Morrow-Howell N. Older adults’ attitudes toward depression treatment modalities: Within-group differences and comparison with their caregivers. Aging Ment Health. 2007;11:422–33.

28.

Areán PA, Reynolds CF. The impact of psychosocial factors on late-life depression. Biol Psychiatry. 2005;58:277–82.PubMedCrossRef

29.

Cohen A, Houck PR, Szanto K, et al. Social inequalities in response to antidepressant treatment in older adults. Arch Gen Psychiatry. 2006;63:50–6.PubMedCrossRef

30.

Choi NG, Lee A, Goldstein M. Meals on Wheels: Exploring Potential for and Barriers to Integrating Depression Intervention for Homebound Older Adults. Home Health Care Serv Q. 2011;30:214–30.PubMedCrossRef

31.

•• Substance Abuse and Mental Health Services Administration Older Americans Behavioral Health Technical Assistance Center. Older Americans behavioral health issue brief: Series overview. 2012. Available at http://www.aoa.gov/AoARoot/AoA_Programs/HPW/Behavioral/docs/OA_Issue_BriefSeriesOverview.pdf. Accessed October 2012. This overview emphasizes the significance of the integration of aging services and mental health services and utilization of technology in doing so.

32.

• Substance Abuse and Mental Health Services Administration Older Americans Behavioral Health Technical Assistance Center. Older Americans behavioral health issue brief 1. 2012. Available at http://www.aoa.gov/AoARoot/AoA_Programs/HPW/Behavioral/docs/OA_IssueBrief1_ServicesNetwork_508_12JUN07_dr.pdf. Accessed October 2012. This issue brief is one of the series produced by the SAMHSA about older adults’ mental health issues.

33.

Bazelais KN, Pickett YR, Bruce ML. Late-life mood disorders and home-based services and interventions. In Late-life mood disorders. Edited by Lavrezsky H, Sajatovi M, Reynolds C. New York: Oxford University Press. In press.

34.

Centers for Medicare and Medicaid Services. Definition of Homebound. Available at http://www.medicare.gov/homehealthcompare/Resources/Glossary.aspx?toolAudiance=HHC&Language=English&TermID=0026. Accessed October 2012.

35.

O’Shaughnessy CV. The Aging Services Network: Accomplishments and Challenges in Serving a Growing Elderly Population. National Health Policy Forum background paper. 2008. April 11. Available at http://www.nhpf.org/library/background-papers/BP_AgingServicesNetwork_04-11-08.pdf. Accessed October 2012.

36.

Administration on Aging. Facts. 2012. Available at http://www.aoa.gov/aoaroot/Press_Room/Products_Materials/fact/pdf/AoA_Factsheet.pdf. Accessed October 2012.

37.

Administration on Aging. Outline of 2006 Amendments to the Older Americans Act. 2011. Available at http://www.aoa.gov/aoaroot/aoa_programs/oaa/oaa.aspx. Accessed October 2012.

38.

Kroenke K, Spitzer RL. The PHQ-9: A new depression diagnostic and severity measure. Psychiat Ann. 2002;32:509–15.

39.

Kroenke K, Spitzer RL, Williams JB. The PHQ-9: Validity of a brief depression severity measure. J Gen Inter Med. 2001;16:606–813.CrossRef

40.

Sheeran T, Reilly CF, Raue PJ, et al. The PHQ-2 on OASIS-C: A new resource for identifying geriatric depression among home health patients. Home Healthc Nurse. 2010;28:92–102.PubMedCrossRef

41.

Saliba D, DiFilippo S, Edelen MO, et al. Testing the PHQ-9 interview and observational versions (PHQ-9 OV) for MDS 3.0. J Am Med Dir Assoc. 2012;13:618–25.PubMedCrossRef

42.

Berman J, Furst LM. Depressed older adults: Education and screening. New York: Springer; 2010.

43.

Richardson TM, He H, Podgorski C, et al. Screening depression aging service clients. Am J Geriatr Psychiatry. 2010;18:1116–23.PubMedCrossRef

44.

• Boyle LL, Richardson TM, He H, et al. How do the PHQ-2, the PHQ-9 perform in aging services clients with cognitive impairment? Int J Geriatr Psychiatry. 2011;26:952–60. This paper reports the first systematic evaluation of PHQ-2 and PHQ-9 among older adults served by aging-service agencies.PubMedCrossRef

45.

Petkus AJ, Gum AM, Small B, et al. Evaluation of the factor structure and psychometric properties of the brief Symptom Inventory-18 with homebound older adults. Int J Geriatr Psychiatry. 2010;25:578–87.PubMed

46.

U.S Department of Health and Human Services, Substance Abuse and Mental Health Services, Center for Mental Health Services Administration. The Treatment of Depression in Older Adults: Selecting Evidence-Based Practices for Treatment of Depression in Older Adults. HHS PubNoSMA-11-4631. 2011. Rockville, MD.

47.

•• Centers for Disease Control and Prevention and National Association of Chronic Disease Directors. The State of Mental Health and Aging in America Issue Brief 2: Addressing Depression in Older Adults: Selected Evidence-Based Programs. Atlanta, GA: National Association of Chronic Disease Directors, 2009. This issue brief provides a summary of selected evidence-based psychotherapies for late-life depression.

48.

D’Zurilla TJ. Problem-solving therapy: A social competence approach to clinical intervention. New York: Springer; 1986.

49.

Nezu AM, Nezu CM, Perri MG. Problem-solving therapy for depression: Theory, research, and clinical guidelines. New York: John Wiley & Sons; 1989.

50.

D’Zurilla TJ, Nezu AM. Problem-Solving Therapy: A positive approach to clinical intervention. New York: Springer; 2007.

51.

Mynors-Wallis L. Problem-solving treatment for anxiety and depression: A practical guide. New York: Oxford University Press; 2005.

52.

Areán PA, Hegel MT, Vannoy S, et al. Effectiveness of problem-solving therapy for older, primary care patients with depression: Results from the IMPACT study. Gerontologist. 2008;48:311–24.PubMedCrossRef

53.

• Areán PA, Raue PJ, Mackin S, et al. Problem-solving therapy and supportive therapy in older adults with major depression and executive dysfunction. Am J Psychiat. 2010;167:1391–8. The paper reports the findings of a large randomized clinical trial that examined the effectiveness of in-person problem-solving therapy vis-à-vis supportive therapy for older adults with mild cognitive impairments.PubMedCrossRef

54.

Alexopoulos GS, Raue PJ, Kiosses DN, et al. Problem-solving therapy and supportive therapy in older adults with major depression and executive dysfunction: Effect on disability. Arch Gen Psychiatry. 2011;68:33–41.PubMedCrossRef

55.

Cuijpers PA, van Straten A, Warmerdam L. Problem-solving therapies for depression: A meta-analysis. Eur Psychiatry. 2007;22:9–15.PubMedCrossRef

56.

Gellis Z, McGinty J, Horowitz A, et al. Problem-solving therapy for late-life depression in home care: A randomized field trial. Am J Geriatr Psychiatry. 2007;15:968–78.PubMedCrossRef

57.

• Choi NG, Hegel MT, Marti CM, et al. Telehealth Problem-Solving Therapy for Depressed Low-Income Homebound Older Adults: Acceptance and Preliminary Efficacy. Am J Geriatr Psychiatry. 2012, Aug 31. Epub ahead of print. PMID: 22948295. This paper reports the feasibility and efficacy of home-based telehealth-delivered problem-solving therapy for depressed, low-income homebound older adults.

58.

Alexopoulos GS, Raue P, Areán PA. Problem-solving therapy versus supportive therapy in geriatric major depression with executive dysfunction. Am J Geriatr Psychiatry. 2003;11:46–51.PubMed

59.

• Kiosses DN, Arean PA, Teri L, Alexopoulos GS. Home-delivered problem adaption therapy (PATH) for depressed, cognitively impaired, disabled elders: A preliminary study. Am J Geriatr Psychiatry. 2010;18:988–98. This paper reports the feasibility and efficacy of findings of a small randomized controlled trial of the PATH program for homebound, cognitively impaired older adults and their caregivers.PubMedCrossRef

60.

Lawton MP, Windely PG, Byerts TO. Aging and the environment: Theoretical approaches. New York: Springer; 1982.

61.

Ciechanowski P, Wagner E, Schmaling K, et al. Community-integrated home-based depression treatment in older adults. JAMA. 2004;29:1569–77.CrossRef

62.

Chaytor N, Ciechanowski P, Miller JW, et al. Long-term outcomes of the PEARLS randomized trial for the treatment of depression in patients with epilepsy. Epilepsy Behav. 2011;20:545–9.PubMedCrossRef

63.

• Steinman L, Cristofalo M, Snowden M. Implementation of an evidenced-based depression care management program (PEARLS): Perspectives from staff and former clients. Prev Chronic Dis. 2012;9:110250. This paper reports barriers to PEARLS delivery and recommended solutions by aging service agency staff.

64.

Quijano LM, Stanley MA, Petersen NJ, et al. Healthy IDEAS: A depression intervention delivered by community based case managers serving older adults. J Applied Gerontol. 2007;26:139–56.CrossRef

65.

Gitlin LN, Harris LF, McCoy M, et al. A community-integrated home based depression intervention for older African Americans: description of the Beat the Blues randomized trial and intervention cost. BMC Geriatr. 2012;12:4.PubMedCrossRef

66.

Sheeran T, Lotterman J, Brown S, et al. Feasibility and impact of telemonitor-based depression care management for geriatric homecare patients. Telemed e-Health. 2011;17:620–6.CrossRef

67.

Bruce ML, Raue PJ, Sheeran T, et al. Depression care for patients at home (Depression CAREPATH): Protocols and implementation, Part 2. Home Healthc Nurse. 2011;29(8):480–9.PubMedCrossRef

68.

Bruce ML, Raue PJ, Reilly CG, et al. Developing and piloting a web-based, long-distance implementation strategy for depression care in home healthcare patients. Presented at the National Institutes of Health Dissemination and Implementation Conference. Washington DC; March 22, 2012.

69.

Aarons GA, Hurlburt M, Horwitz SM. Advancing a conceptual model of evidence-based practice implementation in public service sectors. Adm Policy Ment Health. 2011;38(1):4–23.PubMedCrossRef

70.

Institute of Medicine. The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? A Consensus Report. Washington, DC: National Academies Press; 2012.

71.

Areán PA, Raue PJ, Sirey JA, Snowden M. Implementing evidence-based psychotherapies in settings serving older adults: Challenges and solutions. Psych Serv. 2012;63:605–7.CrossRef

Titel: Depression in Homebound Older Adults: Recent Advances in Screening and Psychosocial Interventions
verfasst von: Namkee G. Choi
Jo Anne Sirey
Martha L. Bruce
Publikationsdatum: 01.03.2013
Verlag: Current Science Inc.
Erschienen in: Current Geriatrics Reports / Ausgabe 1/2013
Elektronische ISSN: 2196-7865
DOI: https://doi.org/10.1007/s13670-012-0032-3

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