Late-life depression is underdiagnosed and undertreated, leading to significant impairments in the physical, cognitive and social functioning of older adults. Limitations in current strategies for assessing depression may contribute to the problem of under-identification. The ability to report accurately on depressive symptoms may be affected by cognitive impairment in elderly persons. Age-related differences in conceptions about mental illness may also influence older adults' recognition of depressive episodes. The purpose of the current study was to test for evidence of these age-related reporting biases using supplemental reports of depression obtained from informants.
A random sample of 539 newly admitted medical homecare patients, aged 65 and older were interviewed using the current mood section of the Structured Diagnostic Interview for DSM-IV (SCID). Informant interviews were also obtained for 355 (66%) of these patients.
Preliminary analyses indicate fair agreement (kappa=.41) between patient and informant reports of major or subsyndromal depression. Among the 275 patients who did not report depression, informants reported that 36 patients (13%) had a depressive disorder. Conversely, among the 56 patients who did report a depressive disorder, informants failed to identify depression in 24 (43%) of these patients. Further analyses will examine whether demographic and clinical characteristics influence these patterns of discrepancy.
These findings suggest that obtaining informant reports of depressive symptoms may be a useful method for increasing identification of late-life depressive disorders. However, using informant reports alone would result in a number of cases not being detected.
Learning Objectives: At the conclusion of the session, the participant in this session will be able to: 1. Describe the basic findings on the prevalence of depression in late-life and identify difficulties in assessing depression in elderly persons. 2. Discuss the usefulness of obtaining informant interviews on depression in elderly persons. 3. Implement procedures for utilizing informant interviews in patients with cogitive impairment and in elderly persons with available confidants
Keywords: Depression, Elderly
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.