Diagnosis and treatment rates for depression in older adults have grow

Research Activities, March 2012, No. 379

Diagnosis and treatment rates for depression in older adults have grown over time, with medication edging out therapy

Depression, quite common in the elderly, can lead to reduced life expectancy, hospitalization, and even suicide. Both drugs and psychotherapy are effective in treating depression, although their combined use has been shown to be more effective than either one alone. A new study found that depression diagnosis and treatment rates have increased over time. In addition, drugs have become the preferred method of treatment over psychotherapy.

Researchers analyzed national Medicare data from 1992 to 2005 on fee-for-service Medicare beneficiaries who lived in the community. They identified individuals with a diagnosis of depression and the types of treatment they received. Between 1992 to 1995 and 2002 to 2005, the overall annual rates of depression in this group doubled from 3.2 percent to 6.3 percent. Along with this increase in diagnosis was an increase in treatment. Antidepressant use increased from 53.7 percent to 67.1 percent. At the same time, the use of psychotherapy declined from 26.1 percent to 14.8 percent. Among those 85 years of age and older, the increased use of antidepressants was greatest, rising from 42 percent to 65 percent. By 2005, less than half of patients with major depressive disorder received psychotherapy. Only 5.6 percent of patients with other depression diagnoses were treated in this manner.

The findings suggest that, despite its benefits, psychotherapy is being underutilized in older patients with depression. The study was supported in part by the Agency for Healthcare Research and Quality (HS16097).

See "Diagnosis and treatment of depression in older community-dwelling adults: 1992-2005," by Ayse Akincigil, Ph.D., Mark Olfson, M.D., James T. Walkup, Ph.D., and others in the Journal of the American Geriatrics Society 59(6), pp. 1042-1051, 2011.

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