Depression Screening in Older Adults

University of Minnesota| Mon Jul 31 11:18:11 EDT 2017
Depression Screening in Older Adults

The number of antidepressants prescribed in the U.S. is skyrocketing as more primary care providers give antidepressants to patients even though many of them don’t have a psychiatric diagnosis. A group of University of Minnesota researchers set out to study how that trend might be affecting older adults. “We found that physicians were less likely to prescribe unnecessary antidepressants when they screened their patients for depression,” said Greg Rhee, Ph.D., M.S.W., primary author of the study affiliated with the College of Pharmacy. The study looked at adults age 65 or older.

Preventive Medicine, utilized data from the National Ambulatory Medical Care Survey. It surveyed primary care physicians to randomly sample over 9,000 visits made among older adults in 2010-2012. Rhee said that potentially inappropriate antidepressants can carry a greater risk of adverse drug events or interact negatively with other medications that older individuals may be taking. In addition, most studies of antidepressants have followed younger populations, and it’s possible that older adults could experience different symptoms and respond differently to treatment. 

“Depression screening is not a perfect science,” Rhee said. “We need to continue to work together to improve accuracy and utility of existing depression screening tools and update existing screening guidelines to provide the best available quality of care for older adults.” Even for those who do present psychiatric conditions, other non-pharmacological treatments, like cognitive behavioral therapy or counseling, can be more effective, depending on individuals’ bio-psycho-social assessments and needs. Out of 9,313 visits analyzed in Rhee’s study, only 209 included a depression screening.

He encourages providers to take a more active role in screening and to take time to talk about mental health with elderly patients. “Depression screening should be actively utilized,” Rhee said. 

“Our study demonstrates it can reduce unnecessary prescriptions, but more importantly, it helps us identify people who may be suffering and to get them the treatment they need.” Rhee worked with other College of Pharmacy researchers on the study including Jon Schommer, Ph.D., R.Ph., Ronald Hadsall, Ph.D., M.S. and Donald Uden, Pharm.D., as well as Benjamin Capistrant, Sc.D., from the U's School of Public Health. 

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