Increasing Identification and Follow-Up of Older Adult Depression in Primary Care

INTRODUCTION

Depression is a common mental health disorder faced by older adults that can go undetected and untreated. It was determined that the project site was not screening for depression among their older patient population. Aims: The purpose of this quality improvement project was to determine if the implementation of the Geriatric Depression Scale-15 (GDS-15) would impact the identification of risk factors for depression and follow-up among adults 65 and older.

METHODS

Implementation started in June 2021 in a primary care office in Southern California. Data was collected for this project over a total of 8 weeks. This project was a quality improvement project designed to implement routine depression screening among older adult patients using the GDS-15. Depressive symptoms were identified, and follow-up and treatment for depression in primary care was initiated if indicated by GDS-15 scores. Data were obtained from the project site's electronic medical record on a total sample size of 443 patients (n = 252 in the comparison group and n = 191 in the implementation group).

RESULTS

A chi-square test indicated a clinical and statistically significant improvement in the identification rate of depression, X2 (1, N = 443) = 49.76, P < .0001; and follow-up rate X2 (1, N = 70) = 23.94, P < .0001. Clinical significance was found with an increase in the identification of depression and follow-up of older adults in primary care. Demographic variables were also compared for the QI intervention group patients according to those who scored <5 (n = 134) and patients who scored 5 or greater on the GDS-15 (n = 57) again using chi-square tests. The results showed significant differences between gender (P = .016) and primary diagnosis (P = .006).

CONCLUSIONS

Findings of this project suggest all older adults should receive a depression screening routinely in primary care to increase the recognition of depression as well as follow-up and treatment.

A Photography-based, Social Media Walking Intervention Targeting Autonomous Motivations for Physical Activity: Semistructured Interviews With Older Women

BACKGROUND

Older adult women are at risk for negative health outcomes that engaging in sustained physical activity can help prevent. However, promoting long-term maintenance of physical activity in this population has proven to be a challenge. Increasing autonomous motivations (ie, intrinsic, integrated, and identified regulations) for physical activity may facilitate enduring behavior change. Digitally delivered games for health that take a celebratory technology approach, that is, using technology to create new ways to experience valued behaviors and express valued beliefs, may be a useful way to target autonomous motivations for physical activity. Formative research with the target population is needed to design compelling intervention content.

OBJECTIVE

The objective of this study is to investigate older adult women's reactions to and thoughts about a photography-based, social media walking game targeting autonomous motivations for physical activity.

METHODS

During an individual semistructured interview, a moderator solicited feedback from 20 older adult women (age range 65-74 years) as part of formative research to develop a social media game featuring weekly walking challenges. The challenges were designed to target autonomous motivations for physical activity. Interviews were audio-recorded and transcribed verbatim. Two reviewers conducted thematic content analysis on interview transcripts.

RESULTS

We identified 3 overarching themes in qualitative data analysis. These reflected the playful experiences, value, and acceptability associated with the intervention challenges. Generally, participants understood what the challenges were asking them to do, proffered appropriate example responses, and indicated that the challenges would be enjoyable. Participants reported that the intervention content afforded many and varied playful experiences (eg, competition, discovery, exploration, expression, fellowship, humor, nurture, sensation). Further, participants indicated that the intervention increased their motivation for physical activity, occasioned meaningful shifts in perspective, increased their knowledge of various topics of interest, provided an opportunity to create valued connection with others, and provided health-related benefits. Participants suggested the intervention emphasize local history, nature, and cultural events.

CONCLUSIONS

The photography-based, social media walking game with relatively simple game mechanics was well received and judged to be apt to bring about a wide variety of emotive experiences. A clear, geographically specific identity emerged as a key driver of interest for intervention content. Taking a celebratory technology approach holds promise for targeting autonomous motivations for physical activity in older adult women.

Factors related to depression in older adults during the COVID-19 pandemic in two coastal regions of Peru: An analytical cross-sectional study

Background: Mental health problems such as anxiety, depression and their aggravation have been studied extensively in the general population. However, there are few studies on depression in older adults and the few existing results may be contradictory, especially in the context of the COVID-19 pandemic. The aim of this study is to determine the factors associated with depression in older adults in two coastal regions of Peru during the COVID-19 pandemic. Methods: This study uses an analytical cross-sectional design in a population of older adults, who participated in a non-governmental ambulatory social support program in Callao and Ica, two coastal regions of Peru. We administered an on-site structured questionnaire to record sociodemographic data, the Geriatric Depression Scale by Yesavage to measure depression, and the Barthel Index to assess physical function. In order to determine cognitive impairment as an exclusion criterion, the MEC-30 was used. The association between variables was assessed through contingency tables, using the odds ratio (OR) with its corresponding confidence interval (95% CI) and the X2 test. Finally, a binary logistic regression analysis was performed. Results: Out of the 244 older adults surveyed, 39% had depressive symptoms, of which 28.3% (n=69) and 10.7% (n=26) were moderately and severely depressive, respectively. The findings significantly associated with the presence of depressive symptoms were being 76 years old or older [p=0.005, OR: 2.33, 95% CI: 1.29-4.20], not participating in weekly recreational activities [p=0.004, OR: 2.28, 95% CI: 1.31-3.99] and the presence of comorbidities [p=0.026, OR: 1.88, 95% CI: 1.07-3.29]. Conclusion: There are few studies exploring depression in older adults during the COVID-19 pandemic; this research shows the importance of mental health care in this population and, particularly, of those who are 76 or older because they suffer from comorbid conditions and have interrupted recreational activities.

Factors related to depression in older adults during the COVID-19 pandemic in two coastal regions of Peru: An analytical cross-sectional study

Background: Mental health problems such as anxiety, depression and their aggravation have been studied extensively in the general population. However, there are few studies on depression in older adults and the few existing results may be contradictory, especially in the context of the COVID-19 pandemic. The aim of this study is to determine the factors associated with depression in older adults in two coastal regions of Peru during the COVID-19 pandemic. Methods: This study uses an analytical cross-sectional design in a population of older adults, who participated in a non-governmental ambulatory social support program in Callao and Ica, two coastal regions of Peru. We administered an on-site structured questionnaire to record sociodemographic data, the Geriatric Depression Scale by Yesavage to measure depression, and the Barthel Index to assess physical function. In order to determine cognitive impairment as an exclusion criterion, the MEC-30 was used. The association between variables was assessed through contingency tables, using the odds ratio (OR) with its corresponding confidence interval (95% CI) and the X2 test. Finally, a binary logistic regression analysis was performed. Results: Out of the 244 older adults surveyed, 39% had depressive symptoms, of which 28.3% (n=69) and 10.7% (n=26) were moderately and severely depressive, respectively. The findings significantly associated with the presence of depressive symptoms were being 76 years old or older [p=0.005, OR: 2.33, 95% CI: 1.29-4.20], not participating in weekly recreational activities [p=0.004, OR: 2.28, 95% CI: 1.31-3.99] and the presence of comorbidities [p=0.026, OR: 1.88, 95% CI: 1.07-3.29]. Conclusion: There are few studies exploring depression in older adults during the COVID-19 pandemic; this research shows the importance of mental health care in this population and, particularly, of those who are 76 or older because they suffer from comorbid conditions and have interrupted recreational activities.

Factors related to depression in older adults during the COVID-19 pandemic in two coastal regions of Peru: An analytical cross-sectional study

Background: Mental health problems such as anxiety, depression and their aggravation have been studied extensively in the general population. However, there are few studies on depression in older adults and the few existing results may be contradictory, especially in the context of the COVID-19 pandemic. The aim of this study is to determine the factors associated with depression in older adults in two coastal regions of Peru during the COVID-19 pandemic. Methods: This study uses an analytical cross-sectional design in a population of older adults, who participated in a non-governmental ambulatory social support program in Callao and Ica, two coastal regions of Peru. We administered an on-site structured questionnaire to record sociodemographic data, the Geriatric Depression Scale by Yesavage to measure depression, and the Barthel Index to assess physical function. In order to determine cognitive impairment as an exclusion criterion, the MEC-30 was used. The association between variables was assessed through contingency tables, using the odds ratio (OR) with its corresponding confidence interval (95% CI) and the X2 test. Finally, a binary logistic regression analysis was performed. Results: Out of the 244 older adults surveyed, 39% had depressive symptoms, of which 28.3% (n=69) and 10.7% (n=26) were moderately and severely depressive, respectively. The findings significantly associated with the presence of depressive symptoms were being 76 years old or older [p=0.005, OR: 2.33, 95% CI: 1.29-4.20], not participating in weekly recreational activities [p=0.004, OR: 2.28, 95% CI: 1.31-3.99] and the presence of comorbidities [p=0.026, OR: 1.88, 95% CI: 1.07-3.29]. Conclusion: There are few studies exploring depression in older adults during the COVID-19 pandemic; this research shows the importance of mental health care in this population and, particularly, of those who are 76 or older because they suffer from comorbid conditions and have interrupted recreational activities.