Depression eventuates in disabilit...

Depression eventuates in disability through decreases in emotional, physical, and cognitive function. Because of a decline in functional retain in older patients, it is especially important to treat reversible causes of disability. Previous studies have indicated that treatment of depression improves character and emotional functioning but not physical functioning. The Improving Mood: Promoting Access to Collaborative Treatment trial studied the event of collaborative treatment of depression forward physical functioning in older adults.

This multicenter consideration enrolled 1,801 depressed primary care patients 60 years and older Patients were randomized to usual care or an educational intervention forward depression managed by a depression clinical specialist who collaborated with the patient and his or her regular physician to exhibit a treatment plan. These patients received a stepped-care plan based in succession treatment response. All patients received a baseline interview and 12-month follow-up issue measures for physical function were based upon the assessment of instrumental activities of daily living (IADLs) and a 12-item scale based forward the Short Form Health scan Burden of illness and self-rated health also were measured.

The average age of patients in the thought was 71 years, with 30 percent reporting impairment of at least single in kind activity of daily living at baseline and 45 percent of participants rating their overall health as fair or poor, indicating a high rate of comorbid conditions. Of the usual care collection 19.3 percent had substantial improvement in depressive symptoms through the whole extent of one year, compared with 446 percent of the intervention cluster The mean between-group differences in functional status scores were 033 at baseline, 108 at three month 157 at six month and 171 at undivided year. Difference in score onward IADLs were 0.08, 0.03, -006 and -015 respectively (indicating no los of IADLs function in the treatment group)

The authors infer that collaborative care for depression management improves functional status in older adults better than usual care. Improvement in depression was proportionate with functional status. IADLs functioning was preserv in the intervention assemblage as opposed to loss of IADLs functioning in the usual care arrange over one year. These findings prompt that effective treatment of depression can turn end for end functional status. However, only undivided half of the patients in the intervention arrange had resolution of their depression during the subject of attention and the differences between clusters though statistically significant, were small. across a large population, however, these small differences might have substantial positive public health implications.

Callahan CM et al. Treatment of depression improves physical functioning in older adults. J Am Geriatr Soc March 2005;53:367-73

CAROLINE WELLBERY, MD

COPYRIGHT 2005 American Academy of Family Physicians

COPYRIGHT 2006 Gale Group