Diagnosing and treating depression gets better in nursing homes but some disparities remain
Research Activities, September 2011, No. 373
Depression is often underdiagnosed and undertreated in nursing homes. This study demonstrated that diagnosis and treatment of depression among nursing home residents has risen significantly in the past decade. Yet some disparities persist, particularly among minority residents and those with significant cognitive impairment or dementia.
Rutgers University researchers used two databases to obtain detailed information on residents aged 65 and over in 5,445 nursing homes located in 8 States. They analyzed data from every year during the period 1999 to 2007. The percentage of residents diagnosed with depression increased from 33.8 percent in 1999 to 51.8 percent in 2007. Diagnosis rates were highest for whites (55.1 percent), followed by Hispanics (48.3 percent), and blacks (39.4 percent). Use of antidepressants also increased steadily, from 71.2 percent of residents in 1999 to 82.8 percent in 2007. However, black residents with depression continued to be less likely than white residents to receive these medications.
In 2007, those less likely to be diagnosed with depression were blacks, residents aged 85 and older, and those with severe cognitive impairment. In addition to blacks, residents with moderate to very severe cognitive impairment, dementia, and total dependence in activities of daily living were significantly less likely to receive antidepressants to treat their depression. While residents with more coexisting medical conditions were more likely to be diagnosed with depression, they were less likely to receive medication. The study was supported in part by the Agency for Healthcare Research and Quality (HS16097).
See "No longer undertreated? Depression diagnosis and antidepressant therapy in elderly long-stay nursing home residents, 1999 to 2007," by Dorothy Gaboda, Ph.D., Judith Lucas, Ed.D., Michele Siegel, Ph.D., Ece Kalay, B.A., and Stephen Crystal, Ph.D., in the April 2011 Journal of the American Geriatric Society 59(4), pp. 673-680, 2011.