Tackling depression in older people

March 4^th 2002

An 18 month, ground breaking study, which aims to improve patients psychological wellbeing and quality of life, has started on the medical wards at the West Suffolk Hospital.

The University of Cambridge, working in partnership with West Suffolk Hospital and the Old Age Psychiatry Department of Local Health Partnerships NHS Trust has initiated the research. The study will be focusing on older patients and examining the effectiveness of integrating physical and mental health care.

Records show that older people with unrecognised depressive symptoms visit their GP more often, are more likely to be admitted to hospital with physical problems and stay longer in hospital. Comprehensive assessment and provision of appropriate packages of care might improve a patient s ability to live independently and reduce the need for hospital admission. The study, which is the first of its kind to be run in the UK, will be testing if this is the case.

Between 25 and 40 percent of older people on medical wards show symptoms of depression which can include, agitation, anxiety, lowered mood and difficulties coping with illness. A total of 1,500 older patients will be interviewed by the research team. Those who are identified as having depressive symptoms (approximately 300 for the study) will be randomly divided into two groups. One will receive integrated healthcare, the other group will receive the usual care provided by the hospital.

Patients randomised to the integrated healthcare model will be seen by Sue Tucker of Local Health Partnerships NHS, a specialist nurse who will liaise with hospital staff and community services to arrange appropriate support and care in the community. This may include contact with voluntary support groups, counselling, particularly where there has been a bereavement, or drug treatment. The specialist nurse will see the patient on several occasions both in the hospital and at home to ensure that the care package is being implemented.

Dr Sarah Cullum, MRC Training Fellow in Health Services Research at the University of Cambridge, who is leading the study said:

"Older people with depressive symptoms tend to worry more about their physical health and therefore consult healthcare professionals more often. If we can diagnose the problem and put measures into place to manage the symptoms we might be able to reduce a patient s dependence on the health system. This will improve the patient s quality of life and free resources for other patients."