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November 28, 2016

Baycrest researchers found that older adults with higher levels of depression saw fewer improvements during physical rehabilitation, a finding that could lead to better treatment and improved recovery for patients.

“Older adults may perform better in rehabilitation programs if we can identify and treat depression early on,” says Dr. Linda Mah, senior investigator on the study. “By treating depression, patients may have greater energy, motivation and interest in completing the program.”

The study, which was published in the journal Archives of Physical Medicine and Rehabilitation, followed older adults admitted into Baycrest’s intensive, short-term rehabilitation program.

This is the first study to examine the effect of depression on a patient’s physical rehabilitation, while also accounting for other physical, cognitive and emotional factors that may impact recovery. Past studies have demonstrated mixed results between depression and rehabilitation outcomes.

About 15 per cent of older adults living in their own homes report significant levels of depressive symptoms, a statistic which is considered high compared to other populations, according to a fact sheet produced by the Canadian Psychological Association. Depression tends to be under-diagnosed among older adults who typically have many medical conditions, says Dr. Mah, a clinician-scientist at Baycrest’s Rotman Research Institute (RRI).

Based on the study’s findings, she suggests older adults complete depression assessments upon admission to inpatient physical rehabilitation programs.

Further studies will need to be done to determine the best depression assessment tool for older adults, says Saba Shahab, a former trainee at the RRI and the study’s lead author. The study explored the use of the Geriatric Depression Scale, a clinical test that takes 10 to 15 minutes for patients to complete, and found its results to be an effective predictor for recovery success.

Research was supported by the AFP Innovation Fund, the Ontario Ministry of Health and Long-Term Care and the Baycrest Department of Psychiatry.

Additional funding could support Dr. Mah’s work in developing behavioural interventions to improve low mood and anxiety caused by depression. She hopes to offer an alternative to antidepressant medication that some older adults are reluctant to try due to potential side effects.

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