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Evidence Summary

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Psychotherapy is effective for treating depression in older adults living in long-term care.

Cody R, Drysdale K  The effects of psychotherapy on reducing depression in residential aged care: A meta-analytic review Clinical Gerontologist. 2013; 36:1, 46-69.

Review question

Is psychotherapy effective for treating depression in older adults living in long-term care?

Background

Depression is a common problem in older adults, but often it is not recognized or treated. Older adults who live in long-term care facilities may be at risk for depression, so it is important that effective ways to prevent and treat depression in older adults are used.

How the review was done

This review included 17 studies with 674 participants. The studies evaluated psychotherapy to treat depression in older adults who ranged in age between 50-98 years. While a diagnosis of depression was not used in all studies, participants all had symptoms suggesting at least mild depression. Psychotherapy was delivered in some studies by a nurse, while in others by a psychologist, and in some cases by both a nurse and psychologist. The therapy was delivered at least once per week lasting between 30 - 90 minutes, with the number of sessions ranging from 4 – 48 sessions.

What the researchers found

The results show that overall psychotherapy was effective in reducing depression in older adults, and the effect was maintained at the follow-up time, which ranged from 6 weeks to 6 months after the intervention. However, psychotherapy was no more effective than other strategies such as general support or discussion groups in 6 of the 17 studies. Psychotherapy delivered in a facility with an integrated model of care, where the therapist works collaboratively with the long-term care staff, was more effective than non-integrated care where the therapist works independently. Integrated care may be more effective because it permits the long-term care staff to extend the benefits of the intervention beyond the time of therapy.

Conclusion

Psychotherapy is effective in treating depression in older adults who live in long-term care facilities. Psychotherapy is even more effective when the therapist works together with the staff in long term care facilities.




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