Author/Authors :
John T. Frederick، نويسنده , , Lesley E. Steinman، نويسنده , , Thomas Prohaska، نويسنده , , William A. Satariano، نويسنده , , Martha Bruce، نويسنده , , Lucinda Bryant، نويسنده , , Paul Ciechanowski، نويسنده , , Brenda DeVellis، نويسنده , , Katherine Leith، نويسنده , , Kevin M. Leyden، نويسنده , , Joseph Sharkey، نويسنده , , Gregory E. Simon، نويسنده , , Nancy Wilson، نويسنده , , Jürgen Unützer، نويسنده , , Mark Snowden and Late Life Depression Special Interest Project Panelists، نويسنده ,
Abstract :
Objectives
To present findings from an expert panel–informed literature review on community-based treatment of late-life depression.
Methods
A systematic literature review was conducted to appraise publications on community-based interventions for depression in older adults. The search was conducted between March and October 2005. An expert panel of mental health, aging, health services, and epidemiology researchers guided the review and voted on quality and effectiveness of these interventions.
Results
A total of 3543 articles were found with publication dates from 1967 to October 2005; of these, 116 were eligible for inclusion. Adequate data existed to determine effectiveness for the following interventions: depression care management, group and individual psychotherapy for depression, psychotherapy targeting mental health, psychotherapy for caregivers, education and skills training (to manage health problems besides depression; and for caregivers), geriatric health evaluation and management, exercise, and physical rehabilitation and occupational therapy. After reviewing the data, panelists rated the depression care management interventions as effective. Education and skills training, geriatric health evaluation and management, and physical rehabilitation and occupational therapy received ineffective ratings. Other interventions received mixed effectiveness ratings. Insufficient data availability and poor study quality prevented the panelists from rating several reviewed interventions.
Conclusions
While several well-described interventions were found to treat depression effectively in community-dwelling older adults, significant gaps still exist. Interventions that did not target depression specifically may be of benefit to older adults, but they should not be presumed to treat depression by themselves. Treating depressed elders may require a multifaceted approach to ensure effectiveness. More research in this area is needed.
