Older people with depression could benefit from non-drug treatments

Depression is common in older age and with an aging population how late-life depression is managed will become increasingly important.

In a new study, researchers suggest mental health in later life should be given greater priority by healthcare professionals.

The study is from the University of Bristol and University College London (UCL).

Nearly 10 percent of adults aged over 75 have major depressive disorder, and over one third sub-threshold depressive symptoms, yet people over the age of 85 are five times less likely to be referred for psychological therapies than people in their 50s.

In the study, the team aimed to explore how healthcare professionals (HCPs) manage depression in older people and referrals to psychological therapies.

In 20 years’ time there will be more than 20 million people over the age of 60 in the UK.

However, late-life depression is often managed in primary care with antidepressants, despite older people saying they would prefer non-drug therapies such as talk therapies, mindfulness, community activities, Internet-based interventions, and bibliotherapy.

The study reviewed 27 qualitative papers that focused on the way that depressive symptoms in the elderly are dealt with in primary care.

The researchers found many HCPs felt that late-life depression was mainly caused by social isolation and functional decline, but appropriate treatments were limited.

Clinicians perceived depression to have associated stigma for older adults, which required time to negotiate.

Limited time in consultations and the complexity of needs in later life meant physical health was often prioritized over mental health, particularly in the frailest patients.

Good management of late-life depression appeared to depend more on the skills and interest of individual GPs and nurses than on any structured approach.

The researchers emphasize the need for mental health in later life to be given greater priority, better training and support of healthcare professionals working in primary care, and greater investment in psychological therapies that are suitable for older adults.

The study is published in the British Journal of General Practice (BJGP).

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Source: British Journal of General Practice (BJGP).