1,226 randomly sampled patients 60-75 years of age were screened for depression and were classified as having major depression, minor depression, or no depression. The 20 primary care practices from which the patients came were randomly assigned to usual care, or a depression care management intervention, which involved a depression care manager who worked with the primary care provider to recommend treatment for depression according to standard guidelines. Patients were followed for two years. Approximately three years after the study ended, death certificates were reviewed to see whether the depression intervention had any effect on mortality.
At follow-up, 223 patients had died. Patients with depression in intervention practices were less likely to have died than those in usual care practices, and risk of death was reduced in patients with major depression, but not in patients with minor depression, or in patients without depression. The benefit seemed to be almost entirely attributable to a reduction in deaths due to cancer. The authors note that the mechanism for the effect is unclear and warrants further investigation.
“The results of this study reveal the need for engaging primary care practices as partners in developing mental health services for older patients,” says Joseph Gallo, MD, MPH, lead author of the study and Associate Professor of Family Medicine and Community Health at the University of Pennsylvania School of Medicine.
The study appears in the current issue of the Annals of Internal Medicine.
