Depressive symptoms are common in seniors receiving in-home and community-based services. In seniors receiving home-delivered meals, 12% reported clinically significant depression (PHQ >9).(177) In seniors receiving home health nursing, 13.5% met criteria for major depression.(178) The 1 -year incidence of major depression in homebound elders was 3%, and the 1-year incidence for minor depression 7%. (179) Thus, the population of seniors receiving aging services is at high risk for depression and an appropriate target for selective and indicated prevention. Prevention is likely to be highly effective in these seniors, who share many of the depression risk factors identified in epidemiologic research (functional impairments, two or more chronic illnesses, low educational level, and living without a partner, which in one Dutch study identified the 8-10% of the senior population at highest risk for depression).(180-181) Interventions targeting this population could reduce the incidence of depression by one-third to one-half, generating large health gains efficiently, with numbers-needed-to-treat as low as 3-5. (182)

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National Institute of Mental Health (NIMH)
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University of Pittsburgh
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