This study was supported by grants from the John A. Hartford Foundation, the California Healthcare Foundation, the Hogg Foundation, and the Robert Wood Johnson Foundation.
Treatment of Depression Improves Physical Functioning in Older Adults
Article first published online: 24 FEB 2005
Journal of the American Geriatrics Society
Volume 53, Issue 3, pages 367–373, March 2005
How to Cite
Callahan, C. M., Kroenke, K., Counsell, S. R., Hendrie, H. C., Perkins, A. J., Katon, W., Noel, P. H., Harpole, L., Hunkeler, E. M., Unützer, J. and for the IMPACT Investigators (2005), Treatment of Depression Improves Physical Functioning in Older Adults. Journal of the American Geriatrics Society, 53: 367–373. doi: 10.1111/j.1532-5415.2005.53151.x
- Issue published online: 24 FEB 2005
- Article first published online: 24 FEB 2005
- physical function;
- physical disability;
- collaborative care management
Objectives: To determine the effect of collaborative care management for depression on physical functioning in older adults.
Design: Multisite randomized clinical trial.
Setting: Eighteen primary care clinics from eight healthcare organizations.
Participants: One thousand eight hundred one patients aged 60 and older with major depressive disorder.
Intervention: Patients were randomized to the Improving Mood: Promoting Access to Collaborative Treatment (IMPACT) intervention (n=906) or to a control group receiving usual care (n=895). Control patients had access to all health services available as part of usual care. Intervention patients had access for 12 months to a depression clinical specialist who coordinated depression care with their primary care physician.
Measurements: The 12-item short form Physical Component Summary (PCS) score (range 0–100) and instrumental activities of daily living (IADLs) (range 0–7).
Results: The mean patient age was 71.2, 65% were women, and 77% were white. At baseline, the mean PCS was 40.2, and the mean number of IADL dependencies was 0.7; 45% of participants rated their health as fair or poor. Intervention patients experienced significantly better physical functioning at 1 year than usual-care patients as measured using between-group differences on the PCS of 1.71 (95% confidence interval (CI)=0.96–2.46) and IADLs of −0.15 (95% CI=−0.29 to −0.01). Intervention patients were also less likely to rate their health as fair or poor (37.3% vs 52.4%, P<.001). Combining both study groups, patients whose depression improved were more likely to experience improvement in physical functioning.
Conclusion: The IMPACT collaborative care model for late-life depression improves physical function more than usual care.