Abstract

BackgroundThe prevalence of depression in the elderly is growing worldwide, and the population aging in China makes depression a major health problem for the elderly adults and a tremendous burden to the society. Effective interventions should be determined to provide an approach solving the problem and improving the situation. This study examined the effectiveness of a mutual recovery program intervention on depressive symptom, sleep quality, and well-being in community-dwelling elderly adults with depressive symptom in Shanghai.MethodsRecruitment was performed between July 2012 and August 2012. Using a cluster randomized wait-list controlled design, we randomized 6 communities (n = 237) into either the intervention group (3 communities, n = 105) or to a wait-list control group (3 communities, n = 132). All participants met the inclusion criteria for depression, which were defined by The Geriatric Depression Scale (GDS-15). From March to May of 2013, participants in the intervention group underwent a 2-month mutual recovery program intervention. The intervention included seven 90-min, weekly sessions that were based on a standardized self-designed schedule. Depression was used as primary outcome at three measurement moments: baseline (T1), before intervention at 24 weeks (T2), and immediately after intervention at 32 weeks (T3). Well-being and sleep quality were used as the secondary outcomes, and were evaluated based on the WHO-5 Well-being Index (WHO-5) and the Self-administered Sleep Questionnaire (SSQ). Finally, a total of 225 participants who completed all the sessions and the three measurements entered the final analysis. Mixed-model repeated measures ANOVAs were performed to estimate the intervention effects.ResultsThere was no significant difference in gender, marriage, age structure, post-work type, and education background between the intervention and control group at baseline. Multivariate ANOVAs showed that there was no significant difference within the groups in terms of sleep, well-being, and depression at baseline and before the intervention. Mixed-model repeated measures ANOVAs detected a group × time interaction on depression, sleep, and well-being and showed a favorable intervention effect within groups immediately after the intervention.ConclusionsThe mutual recovery program could be a creative and effective approach to improve mental health in older community-dwelling adults with depressive symptom.

Highlights

  • The prevalence of depression in the elderly is growing worldwide, and the population aging in China makes depression a major health problem for the elderly adults and a tremendous burden to the society

  • There was no significant difference between the intervention group and the control group in terms of gender, marriage, age structure, post-work type, and educational background (P > 0.05)

  • The time simple effects on sleep, well-being and depressive symptom were statistically significant in the intervention group (F = 14.452, P = 0.003; F = 72.642, P < 0.001; F = 102.947, P < 0.001, respectively) and not significant in the wait-list control group

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Summary

Introduction

The prevalence of depression in the elderly is growing worldwide, and the population aging in China makes depression a major health problem for the elderly adults and a tremendous burden to the society. Major depression disorders are common among older adults and costs almost 80 billion dollars per year in China [3]; approximately, 10% elderly community-dwelling residents and 15% to 25% of hospitalized patients develop major depression [4]. This percentage would reach 35% with the inclusion of mild depression [5]. CBT is based on Beck’s (1979) cognitive theory of depression and aims to correct the faulty or maladaptive cognitive thinking and lead to changes in both behavior and affect Other strategies such as exercise program, social interaction promotion, and relaxing techniques are often integrated into the CBT, which could help decrease depressive symptoms [10]. Access to face to face CBT is relatively limited because its delivery mode requires adequate therapist time and effort per treatment [14]

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