Presented at Gerontological Association of America Symposium, Psychotropic Drug Use in the Frail Elderly: Issues and Challenges, Atlanta, Georgia, November 19, 2009.
No Longer Undertreated? Depression Diagnosis and Antidepressant Therapy in Elderly Long-Stay Nursing Home Residents, 1999 to 2007
Article first published online: 15 MAR 2011
© 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 59, Issue 4, pages 673–680, April 2011
How to Cite
Gaboda, D., Lucas, J., Siegel, M., Kalay, E. and Crystal, S. (2011), No Longer Undertreated? Depression Diagnosis and Antidepressant Therapy in Elderly Long-Stay Nursing Home Residents, 1999 to 2007. Journal of the American Geriatrics Society, 59: 673–680. doi: 10.1111/j.1532-5415.2011.03322.x
- Issue published online: 14 APR 2011
- Article first published online: 15 MAR 2011
- nursing home;
OBJECTIVES: To examine the evolution of depression identification and use of antidepressants in elderly long-stay nursing home residents from 1999 through 2007 and the associated sociodemographic and facility characteristics.
DESIGN: Annual cross-sectional analysis of merged resident assessment data from the Minimum Data Set (MDS) and facility characteristics from the Online Survey Certification and Reporting data.
SETTING: Nursing homes in eight states (5,445 facilities).
PARTICIPANTS: Long-stay nursing home residents aged 65 and older (2,564,687 assessments).
MEASUREMENTS: Physician-documented depression diagnoses recorded in the MDS were used to identify residents with depression; antidepressant use was measured using MDS information about residents' receipt of an antidepressant in the 7 days before assessment.
RESULTS: Diagnosis of depression and antidepressant therapy in residents diagnosed increased at a rapid rate. By 2007, 51.8% of residents were diagnosed with depression, 82.8% of whom received an antidepressant. Adjusted odds of treatment were higher for younger residents, whites, and those with moderate impairment of cognitive function.
CONCLUSION: This study demonstrates striking increases in depression diagnosis and treatment with antidepressant medications, but disparities persist without clear evidence about underlying mechanisms. More research is needed to assess effectiveness of antidepressant prescribing.