Sarah Pressman Lovinger has a medical degree and is a freelance writer in Evanston, Ill. CHICAGO — Evidence-based guidelines are needed to drive best-treatment practices for managing depression in the elderly, a panel of experts concluded at a joint conference of the American Society on Aging and the National Council on Aging. Yet the panel also acknowledged that limited data are available on elderly people with depression, especially those in nursing home settings. And while some of the experts debated whether evidence-based medicine adequately addresses the needs of individual patients, these mental health practitioners acknowledged that undertreated depression in the elderly is a serious problem, especially among the residents of long-term care facilities. “The mental health community needs to do a better job of getting on the evidence-based bandwagon,” said Sharon Dumberg-Lee, a licensed certified social worker at the Council for Jewish Elderly in Chicago. “We care about depression because it's a fairly common psychiatric disorder, and because it causes a fair amount of morbidity,” said Dr. John Frederick, a psychiatrist at the University of Washington, Seattle. Depression in older adults complicates chronic medical conditions and, if it is not properly treated, can lead to self-neglect, premature death, and suicide. But giving credence to the importance of addressing depression does not necessarily translate into adequate treatment. “Older adults are often suboptimally treated,” Dr. Frederick said. Dr. Frederick and his colleague Dr. Mark Snowden, along with other experts in the Depression Special Interest Project, sponsored by the Centers for Disease Control and Prevention, performed a literature review on treatment of depression in people over age 60 years, Given the small number of studies conducted to date, their evaluations were limited to depression in community settings. The investigators found 174 studies, each with 25 or more community-dwelling adults who were at least 60 years old and in treatment for a wide range of depressive disorders. They concluded that two types of treatment improve outcomes in this population: cognitive-behavioral therapy, and depression care management both in the home and in the primary care clinic. The project also indicated that certain interventions do not seem to benefit older adults who seek treatment for depression. These treatment modes included individual psychotherapy, education skills training, and exercise. The project findings are a good first step for guiding therapeutic decisions in depressed people over age 60, but the limited amount of data point to the need for additional research and more targeted research in specific populations of elderly adults. Further, research on the prevention of depression and suicide in the elderly is lacking. “Suicide is a very tough area to study,” Dr. Frederick said. But even in areas where evidence-based recommendations can be made, data are often disregarded in real-world practice, said Dr. Snowden. Many physicians “treat patients all the time, and they get better,” he explained, even though the treatment plans and outcomes may not fit neatly into a publishable research study. He urged mental health professionals to contribute to the knowledge base by participating in research projects. “We already know there's a gap between evidence-based research and use in community settings,” said Lynda A. Anderson, Ph.D., director of Health Aging Program at the CDC. Reaching out to social service agencies to promote evidence-based research is an important step toward improving the treatment of depression.