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Treatment of Depression Improves Physical Functioning in Older Adults
Author(s) -
Callahan Christopher M.,
Kroenke Kurt,
Counsell Steven R.,
Hendrie Hugh C.,
Perkins Anthony J.,
Katon Wayne,
Noel Polly Hitchcock,
Harpole Linda,
Hunkeler Enid M.,
Unützer Jürgen
Publication year - 2005
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2005.53151.x
Subject(s) - medicine , depression (economics) , randomized controlled trial , mood , collaborative care , confidence interval , activities of daily living , intervention (counseling) , clinical trial , health care , physical therapy , gerontology , mental health , psychiatry , economic growth , economics , macroeconomics
Objectives: To determine the effect of collaborative care management for depression on physical functioning in older adults. Design: Multisite randomized clinical trial. Setting: Eighteen primary care clinics from eight healthcare organizations. Participants: One thousand eight hundred one patients aged 60 and older with major depressive disorder. Intervention: Patients were randomized to the Improving Mood: Promoting Access to Collaborative Treatment (IMPACT) intervention (n=906) or to a control group receiving usual care (n=895). Control patients had access to all health services available as part of usual care. Intervention patients had access for 12 months to a depression clinical specialist who coordinated depression care with their primary care physician. Measurements: The 12‐item short form Physical Component Summary (PCS) score (range 0–100) and instrumental activities of daily living (IADLs) (range 0–7). Results: The mean patient age was 71.2, 65% were women, and 77% were white. At baseline, the mean PCS was 40.2, and the mean number of IADL dependencies was 0.7; 45% of participants rated their health as fair or poor. Intervention patients experienced significantly better physical functioning at 1 year than usual‐care patients as measured using between‐group differences on the PCS of 1.71 (95% confidence interval (CI)=0.96–2.46) and IADLs of −0.15 (95% CI=−0.29 to −0.01). Intervention patients were also less likely to rate their health as fair or poor (37.3% vs 52.4%, P< .001). Combining both study groups, patients whose depression improved were more likely to experience improvement in physical functioning. Conclusion: The IMPACT collaborative care model for late‐life depression improves physical function more than usual care.