Depression is common amongst older people, with one in seven meeting the criteria for full-blown depression. Older people at the greatest risk of depression are those who suffer from loneliness and long-term illnesses, both of which affect this age group disproportionately.
Being depressed can also make health problems worse and older people with depression are at an increased risk of dying. The CASPER clinical trial focussed on older people with lower-severity symptoms who are at the highest risk of becoming clinically depressed.
CASPER is the largest-ever study of its kind and is reported in the Journal of the American Medical Association (JAMA). York based researchers showed that a simple and low-cost intervention reduced the symptoms of depression in older people (aged 65 and over).
Those who received the intervention were also less likely to be more severely depressed after a year. Older people were also less anxious and had improved quality of life compared to people who just received care from their GP.
“We developed our Collaborative Care intervention after consulting with older people and considering evidence about effective treatments for depression.” said study manager, Kate Bosanquet, from the University of York’s Department of Health Sciences.
“We used a simple psychological approach known as behavioural activation. Older people were encouraged to re-engage with social activity and to find alternative ways of being mentally or physically active. This is important since people with depression commonly withdraw from these types of activities and this makes things worse.”
“Older people found Collaborative Care to be an acceptable way of accessing help,’ said Della Bailey, one of the therapists working on the study.
“We mostly worked with people over the telephone and found that participants appreciated this approach. This also meant that older people did not have to travel to hospital to receive psychological care.”
The study team, which also included researchers from the NHS, other universities and the Hull York Medical School are now planning to train NHS therapists in Collaborative Care to ensure that older people all over the UK can benefit from this intervention.
“‘This is the largest rigorous study of its kind and we are very grateful to the National Institute for Health Research, which funded our work, and to the hundreds of older people who participated in the study,” said Chief Investigator, Professor Simon Gilbody.
“‘There is currently very little in the way of psychological treatment offered for older people. We hope that our research will improve the lives of older people throughout the UK.”
- The study, entitled “Effect of Collaborative Care vs Usual Care on Depressive Symptoms in Older Adults With Subthreshold Depression” has been published in JAMA: The Journal of the American Medical Association (http://jamanetwork.com/). JAMA is one of the leading healthcare journals in the world. The journal’s Impact Factor (37.68) is one of the highest in medicine and science.
- Professor Simon Gilbody leads the Mental Health and Addiction Research Group (MHARG), a leading UK centre for large pragmatic trials and related studies. MHARG is part of the University of York’s Department of Health Sciences which has an international reputation for research that improves health and healthcare.
- The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. The NIHR is the research arm of the NHS. Since its establishment in April 2006, the NIHR has transformed research in the NHS. For further information, visit the NIHR website (www.nihr.ac.uk).
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