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A systematic review of community-based health interventions on depression for older adults with heart disease
- Authors:
- KANG-YI Christina D., GELLIS Zvi D.
- Journal article citation:
- Aging and Mental Health, 14(1), January 2010, pp.1-19.
- Publisher:
- Taylor and Francis
This systematic review examines the effectiveness of community-based heart-health interventions on depression outcomes among homebound elderly (64 years and older) with heart disease. People with heart disease who are depressed have an increased risk of death after a heart attack, and therefore treatment for depression in conjunction with heart disease may help patients to manage both diseases. A comprehensive literature search and meta-analysis was performed to evaluate randomised controlled trials examining outpatient or home-based interventions. The methodological quality was assessed by standard criteria developed by the Cochrane Collaborative Initiative. This identified 15 studies which met the inclusion criteria and all measured depression outcomes. The studies differed in scope and methodological rigor and sample sizes varied widely. Problems in treatment fidelity and masking of group assignment were noted. Great variability was found in depression outcomes due to the differences in methodology and intervention. Five studies reported significant treatment effect on depression; three of those employed home-based interventions and two were outpatient-clinic interventions. Ten studies were included in the meta-analysis and the mean weighted effect size was 0.11, with 6 studies showing a positive effect size. The article concludes that mixed evidence for community-based heart disease interventions on depression outcomes was found. Future intervention studies should conduct more rigorous trials over longer time periods and consider using the Consolidated Standards of Reporting Trials (CONSORT).
Psychological treatment of late-life depression: a meta-analysis of randomized controlled trials
- Authors:
- CUIJPERS Pim, VAN STRATEN Annemieke, SMIT Filip
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(12), December 2006, pp.1139-1149.
- Publisher:
- Wiley
Older meta-analyses of the effects of psychological treatments for depression in older adults have found that these treatments have large effects. However, these earlier meta-analyses also included non-randomized studies, and did not include newer high-quality randomized controlled trials. The authors conducted a meta-analysis of randomized studies on psychological treatments for depression in older adults. Twenty-five studies were included, of which 17 compared a psychological intervention to a control condition (mainly waiting list and care-as-usual control groups). The quality of the included studies varied. Psychological treatments have moderate to large effects on depression in older adults (standardized mean effect size d = 0.72). Heterogeneity was very low. No differences were found between individual, group or bibliotherapy format, or between cognitive behavioural therapy and other types of psychological treatment. The effects were comparable in studies where depression was defined according to diagnostic criteria, and those in which depression was measured with self rating questionnaires. Although the quality of many studies was not optimal, the results of this meta-analysis support.
Benchmarks for evaluating life review and reminiscence therapy in alleviating depression among older adults
- Authors:
- RUBIN Allen, PARRISH Danielle E., MIYAWAKI Christina E.
- Journal article citation:
- Social Work: A journal of the National Association of Social Workers (NASW), 64(1), 2019, pp.61-72.
- Publisher:
- Oxford University Press
The efficacy of reminiscence and life review (LR) therapy in alleviating depression among older adults is well established. However, providers in nonresearch settings might implement these interventions inadequately, and such settings rarely can evaluate their outcomes using control groups. Alternatively, evaluators in such settings can calculate a within-group effect size and then compare it with average within-group effect size benchmarks derived from the randomized clinical trials (RCTs) supporting the intervention’s effectiveness. This study developed these within-group effect size benchmarks. A search of RCTs from five systematic reviews and meta-analyses, and more recent RCTs published through 2016, yielded 25 studies that met inclusion criteria. Hedge’s g for LR recipients and waitlist controls were .598 and –.20, respectively, and .568 and –.012 for reminiscence theory. These benchmarks offer an approach for evaluating the implementation of LR and reminiscence therapy when control groups are infeasible. (Publisher abstract)
Effectiveness of home treatment for elderly people with depression: randomised controlled trial
- Authors:
- KLUG Gunter, et al
- Journal article citation:
- British Journal of Psychiatry, 197(6), December 2010, pp.463-467.
- Publisher:
- Cambridge University Press
This study tested the effectiveness of home treatment for elderly people with depression living independently in Austria. Sixty out-patients aged 65 and over with major depression were either allocated to a home treatment model over a 1-year period or to conventional psychiatric out-patient care. Home treatment was delivered by a multidisciplinary team consisting of one psychiatrist, two psychologists and one social worker who was also qualified as a psychiatric nurse. Treatment included talks about self-esteem, coping resources and medication adherence; encouragement to establish and maintain social networks, increase social and leisure activities and cope with tasks of daily living; support of carers; and crisis interventions when required. The primary outcome was the level of depressive symptoms after 3 and 12 months. The secondary outcomes were global functioning, subjective quality of life, admissions to nursing homes, duration of psychiatric hospital treatments and the cost of care. Findings revealed that the individuals receiving home treatment had significantly fewer symptoms of depression, better global functioning and a higher quality of life at 3 months and at 12 months. In the 1 year period there were fewer admissions to nursing homes, they spent less time in psychiatric in-patient care and the overall cost of care was lower. The study concluded that home treatment appeared to be an effective and cost-effective service model for elderly people with depression.
A randomised controlled trail of the effects of multi-sensory stimulation (MSS) for older people with dementia
- Authors:
- BAKER Roger, et al
- Journal article citation:
- British Journal of Clinical Psychology, 40(1), March 2001, pp.81-96.
- Publisher:
- Wiley
Article investigates short-term effects of Multi-Sensory Stimulation (MSS) on behaviour, mood and cognition of older adults with dementia. Through a randomised controlled trial comparing MSS with a credible control of one-to-one activities. Fifty patients with diagnoses of moderate to severe dementia were randomised to either MSS or Activity groups. Immediately after MSS and Activity sessions patients talked more spontaneously, related better to others, did more from their own initiative, were less bored/inactive, and were more happy, active or alert. Both groups were more attentive to their environment than before, with a significantly greater improvement from the MSS group. At a day hospital, patients in the Activity group improved on their 'speech skills' where as the MSS group remained unchanged during the trial. The MSS group showed a significant improvement in mood and behaviour at home compared to the Activity group behaviour deteriorated. No longer-term benefits were shown; , behaviour declined sharply during the month follow-up period. Concludes that both MSS and Activity sessions appear to be effective and appropriate therapies for people with dementia.
Randomised controlled trial of effect of intervention by psychogeriatric team on depression in frail elderly people at home
- Authors:
- BANERJEE Sube, et al
- Journal article citation:
- British Medical Journal, 26.10.96, 1996, pp.1058-1061.
- Publisher:
- British Medical Association
Investigates the efficacy of intervention by a psychogeriatric team in the treatment of depression in elderly disabled people receiving home care from their local authority.