Investigating Care Models to Support Older Adults with Depression and Health Comorbidities

This work was sponsored by National Network of Depression Centers (NNDC) Geriatric Mood Disorders Task Group and the Depression and Bipolar Support Alliance (DBSA) Geriatric depression is frequently associated with health comorbidities. People with depression hold unique perspectives regarding the impact of their condition, experiences of care throughout their lifetimes, and treatment goals, which may not align with clinician perceptions. Recognition of these discrepancies prompts research to better identify best practices for older adults with depression/health comorbidities. A survey of older adults with depression/health comorbidities and their peers (n = 571; 73.4 % and 14.0% respectively) to identify treatment priorities, preferred treatment outcomes, and unmet clinical needs was performed. Results were analyzed using standard and ordered logistic regression models to estimate the effects of comorbidities. Respondents were a majority: female (81.7%), aged 60 to 69 (50.6%), with at least one health comorbidity (96.8%) - commonly hypertension (52.9%) and osteoarthritis (49.7%). 82.6% reported their comorbidity influenced depression management, especially self-care (45.2%) and appointment attendance (31.4%). Subjects with Alzheimer’s disease (AD) (OR = 8.11, CI: 1.90 – 56.07) were less likely to attend appointments for depression treatments. Subjects with heart disease (OR = 1.90, CI: 1.08 – 3.36), persistent pain (OR = 1.62, CI: 1.06 – 2.46), and obesity (OR = 1.81, CI: 1.17 – 2.82) were more likely to report their comorbidity’s influence on self-care. Providers were more likely to ask patients with digestive disorders about depression (OR = 1.55, CI: 1.04 – 2.31). Although 67.9% of providers never addressed potential medication interactions, comorbid heart disease (OR = 2.33, CI: 1.34 – 4.06) and AD (OR = 4.75, CI: 1.32 – 17.08) prompted frequent discussion.