Abstract
BackgroundLate life depression (LLD), a common mental disorder, has become an increasingly acute public health concern with a quickly expanding geriatric population worldwide. To our knowledge, however, the incidence of LLD in northern cities in China has not been empirically investigated, and many elderly people with depressive moods and mild depressive symptoms have not been given sufficient attention.Methods/DesignThis is a multi-stage and prospective study. The first stage is a cross-sectional study, investigating the epidemiological characteristics of LLD in northern China and exploring the biological, psychological, and social risk factors for developing LLD based on a set of questionnaires from 6,800 community-residing elderly adults. The second stage involves statistical analysis, by constructing a risk factor model for LLD and analyzing their direct and indirect functional routes on the basis of structural equation modeling. The third stage is an experimental study a total of 60 elderly patients with LLD and their principle caregivers will be randomly assigned to control and trial groups. The trial group patients and caregivers will undergo supportive psychosocial, drug treatment, and health education (PDH) intervention, whereas the control group patients and caregivers will be treated routinely (treatment as routine, TAR, which includes drug treatment and health education). At the end of the intervention, depressive symptoms, quality of life, and the social and cognitive functioning of the patients in the two groups will be respectively assessed at a baseline and after 6, 9, and 12 months post-intervention by employing scales and questionnaires to analyze the effectiveness of the supportive PDH intervention measures in comparison with TAR. Ultimately, a supportive PDH intervention and health management model will be obtained by combining PDH intervention with mental health institutions, community health services, and aging families as the main line.DiscussionThis study will provide strong and suitable evidence for enhancing the integrated supportive PDH intervention and health management model of LLD patients among community-dwelling residents.EthicsThis study has been approved by the Ethics and Research Committee of the First Affiliated Hospital of China Medical University (approval No. [2019] 2019-312-2).
Highlights
Late life depression (LLD) is complex, burdensome, and difficult to treat
Studies have found that it is difficult to improve the cognition and personality traits of elderly patients with pharmacotherapy alone, and a number of adverse events are often associated with antidepressant use. This leads to discontinuation, which contributes to a high recurrence rate and mortality [13, 14]
The prevalence and detection rate of LLD has gradually increased over the past several years, and LLD affects an increasing number of elderly people and their families
Summary
Late life depression (LLD) is complex, burdensome, and difficult to treat. it refers to elderly people who, for the first time in their lives, meet criteria for major depressive disorder (MDD) or display clinically significant depressive symptoms such as functional disability, cognitive decline, increased risk of medical comorbidity (e.g., co-dementia), and even suicide in severe cases [1,2,3,4]. Studies have found that it is difficult to improve the cognition and personality traits of elderly patients with pharmacotherapy alone, and a number of adverse events (e.g., cardiovascular, gastrointestinal, and anticholinergic complications) are often associated with antidepressant use This leads to discontinuation, which contributes to a high recurrence rate and mortality [13, 14]. Various forms of non-pharmacological therapies with negligible side effects are being embraced by patients, such as meditation, motor therapy, cognitive behavioral therapy, interpersonal psychotherapy, reminiscence therapy, alternative therapies, and group or educational activities [15,16,17,18,19] These treatments are tailored to the abilities of elderly patients and target multiple contributing factors with the aim of alleviating loneliness and comorbid anxiety, enhancing social support, and improving QOL. The incidence of LLD in northern cities in China has not been empirically investigated, and many elderly people with depressive moods and mild depressive symptoms have not been given sufficient attention
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