Clinical detection of depression among community-based elderly people with self-reported symptoms of depression

Judith Garrard, Sharon Judith Rolnick, Nicole M. Nitz, Lori Luepke, Jody Jackson, Lucy Rose Fischer, Cynthia Leibson, Patricia C. Bland, Richard Heinrich, Lance A. Waller

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93 Scopus citations

Abstract

Background. Depression is under-diagnosed and under-treated in the primary care sector. The purpose of this study was to determine the association between self-reported indications of depression by community- dwelling elderly enrollees in a managed care organization and clinical detection of depression by primary care clinicians. Methods. This was a 2- year cohort study of elderly people (n = 3410) who responded to the Geriatric Depression Scale (GDS) at the midpoint of the study period. A broad measure of clinical detection was used consisting of one or more of three indicators: diagnosis of depression, visit to a mental health specialist, or antidepressant medication treatment. Results. Approximately half of the community-based elderly people with self-reported indications of depression (GDS ≤ 11) did not have documentation of clinical detection of depression by health providers. PhySician recognition of depression tended to increase with the severity of enrollees' self-reported feelings of depression. Men 65-74 years old and those ≤85 years old were at highest risk for under-detection of depression by primary care providers. Conclusions. Clinical detection of depression of elderly people living in the community continues to be a problem. The implications of failure to recognize the possibility of depression among elderly White men suggest a serious public health problem.

Original languageEnglish (US)
Pages (from-to)M92-M101
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume53
Issue number2
DOIs
StatePublished - Jan 1 1998

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology

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    Garrard, J., Rolnick, S. J., Nitz, N. M., Luepke, L., Jackson, J., Fischer, L. R., Leibson, C., Bland, P. C., Heinrich, R., & Waller, L. A. (1998). Clinical detection of depression among community-based elderly people with self-reported symptoms of depression. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 53(2), M92-M101. https://doi.org/10.1093/gerona/53A.2.M92