Study: Depression Can Be Treated in Seniors

Successful treatment of depression in frail older people may help slow their physical decline, which could help keep them living independently as long as possible, a new study says.

The findings suggest that doctors more aggressively identify and treat seniors with depression, an illness that puts people, especially the elderly, at risk of suicide. Many doctors mistakenly believe that treatment doesn’t help older people suffering from depression.

Not so, says Christopher Callahan, a geriatric researcher at the Indiana University School of Medicine in Indianapolis. Depression can be harder to treat in seniors, but this study and others suggest that treatment does work for many people. And when the fog of depression lifts, they find they’re better able to perform routine but crucial tasks.

”If you can slow the rate of decline, then you’re forestalling dependency and nursing home placement,” he says.

Callahan and his colleagues studied about 1,800 people age 60 and older who had symptoms of a major depression, such as crying spells or a loss of interest in activities. They all had been depressed for a year and often had many other health problems.

Half the group got standard care for depression from their primary-care doctor. Half got more intensive treatment from a team that included their own doctor and a nurse or social worker specially trained to handle depression.

People in the study typically got antidepressant drugs but more seniors in the intensive care group improved — possibly because the nurse or social worker kept close track of the depression and offered a different drug if the initial medication didn’t work. People who got effective treatment showed the most improvement in two key areas: managing money and keeping track of daily medication, Callahan says.

The study is in the March Journal of the American Geriatrics Society.

Treatment of the depression may interrupt a downward spiral of abilities that can put seniors at risk of nursing home placement, says Dan Blazer, a geriatric-medicine expert at Duke University who wrote an editorial in the journal. Depression may interrupt a senior’s routine, which may be further disrupted by a physical problem such as a bad fall. But if the health problem clears up and the depression remains, a senior is at risk of not going back to his or her former pattern: They may stop paying bills or preparing meals and may suddenly need help every day, Blazer says.

Families are often the first to notice an older person’s blue mood, says David Oslin, a geriatric specialist at the University of Pennsylvania. Seniors who suddenly have trouble sleeping or who appear sad or excessively worried may be suffering from depression, he says. Family members should ask the doctor directly about such symptoms because many seniors won’t admit they’re feeling depressed.