Treatment of depression improves physical functioning in older adults

Christopher Callahan, Kurt Kroenke, Steven Counsell, Hugh Hendrie, Anthony J. Perkins, Wayne Katon, Polly Hitchcock Noel, Linda Harpole, Enid M. Hunkeler, Jürgen Unützer

Research output: Contribution to journalArticle

133 Citations (Scopus)

Abstract

OBJECTIVES: To determine the effect of collaborative care management for depression on physical functioning in older adults. DESIGN: Multisite randomized clinical trial. SETTING: Eighteen primary care clinics from eight healthcare organizations. PARTICIPANTS: One thousand eight hundred one patients aged 60 and older with major depressive disorder. INTERVENTION: Patients were randomized to the Improving Mood: Promoting Access to Collaborative Treatment (IMPACT) intervention (n = 906) or to a control group receiving usual care (n = 895). Control patients had access to all health services available as part of usual care. Intervention patients had access for 12 months to a depression clinical specialist who coordinated depression care with their primary care physician. MEASUREMENTS: The 12-item short form Physical Component Summary (PCS) score (range 0-100) and instrumental activities of daily living (IADLs) (range 0-7). RESULTS: The mean patient age was 71.2, 65% were women, and 77% were white. At baseline, the mean PCS was 40.2, and the mean number of IADL dependencies was 0.7; 45% of participants rated their health as fair or poor. Intervention patients experienced significantly better physical functioning at 1 year than usual-care patients as measured using between-group differences on the PCS of 1.71 (95% confidence interval (CI) = 0.96-2.46) and IADLs of -0.15 (95% CI = -0.29 to -0.01). Intervention patients were also less likely to rate their health as fair or poor (37.3% vs 52.4%, P < .001). Combining both study groups, patients whose depression improved were more likely to experience improvement in physical functioning. CONCLUSION: The IMPACT collaborative care model for late-life depression improves physical function more than usual care.

Original languageEnglish
Pages (from-to)367-373
Number of pages7
JournalJournal of the American Geriatrics Society
Volume53
Issue number3
DOIs
StatePublished - Mar 2005

Fingerprint

Depression
Activities of Daily Living
Health Fairs
Therapeutics
Confidence Intervals
Major Depressive Disorder
Primary Care Physicians
Health Services
Primary Health Care
Patient Care
Randomized Controlled Trials
Delivery of Health Care
Control Groups

Keywords

  • Collaborative care management
  • Depression
  • Physical disability
  • Physical function

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Treatment of depression improves physical functioning in older adults. / Callahan, Christopher; Kroenke, Kurt; Counsell, Steven; Hendrie, Hugh; Perkins, Anthony J.; Katon, Wayne; Noel, Polly Hitchcock; Harpole, Linda; Hunkeler, Enid M.; Unützer, Jürgen.

In: Journal of the American Geriatrics Society, Vol. 53, No. 3, 03.2005, p. 367-373.

Research output: Contribution to journalArticle

Callahan, Christopher ; Kroenke, Kurt ; Counsell, Steven ; Hendrie, Hugh ; Perkins, Anthony J. ; Katon, Wayne ; Noel, Polly Hitchcock ; Harpole, Linda ; Hunkeler, Enid M. ; Unützer, Jürgen. / Treatment of depression improves physical functioning in older adults. In: Journal of the American Geriatrics Society. 2005 ; Vol. 53, No. 3. pp. 367-373.
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