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).^^^ In seniors receiving home health nursing, 13.5% met criteria for major depression.''^^ The 1 -year incidence of major depression in homebound elders was 3%, and the 1-year incidence for minor depression 7%.^^^ 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).^^'^^^ 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.^^^

Public Health Relevance

REL The Principal Research Core will support three depression prevention trials and one methods development project. The prevention trials will enroll a total of 450 older adults with physical, cognitive, and psychosocial vulnerabilities to depression, testing the ability of learning-based interventions to protect from depression;while the methods development project, using data pooled across each of these trials, will develop practical ways to help clinicians apply preventive interventions in an on-target, on-time way to maximize efficiency and impact.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Center Core Grants (P30)
Project #
5P30MH090333-04
Application #
8659202
Study Section
Special Emphasis Panel (ZMH1-ERB-F)
Project Start
Project End
Budget Start
2014-05-01
Budget End
2015-04-30
Support Year
4
Fiscal Year
2014
Total Cost
$33,329
Indirect Cost
$11,330
Name
University of Pittsburgh
Department
Type
DUNS #
004514360
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
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Buysse, Daniel J; Rush, A John; Reynolds 3rd, Charles F (2017) Clinical Management of Insomnia Disorder. JAMA 318:1973-1974
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