Department of Old-age Psychiatry, GGNet, Apeldoorn/Zutphen, the Netherlands.
University Medical Center Groningen, University Center for Psychiatry, University of Groningen, Groningen, the Netherlands.
Int J Ment Health Nurs. 2022 Aug;31(4):823-842. doi: 10.1111/inm.12982. Epub 2022 Feb 9.
Depression is one of the most prevalent mental disorders in older adults and leads to considerable decreases in health, well-being, and impaired functioning. Intervention studies have focused on the effects on symptomatic recovery, and most do not include functional recovery as an outcome. Reduction of functional limitations as a treatment goal in old-age psychiatry aligns with the values of older persons. The objective of this review was therefore to evaluate the effectiveness of late-life depression interventions on functional limitations. This systematic review identified 15 randomized controlled trials in which the effectiveness of different interventions on functional limitations was evaluated in patients with late-life depression. The interventions were categorized into four categories: psychological interventions, drug treatment, physical exercise, and collaborative care. Multicomponent and collaborative-care interventions appear to be the most promising for improvement of functional limitations, particularly in primary care and community-dwelling populations of older persons with symptoms of depression. There is, however, a lack of evidence regarding studies in specialized mental health care.
抑郁症是老年人中最常见的精神障碍之一，会导致健康状况、幸福感显著下降，以及功能受损。干预研究集中在症状缓解的效果上，大多数研究都没有将功能恢复作为结果。将减少功能限制作为老年精神病学的治疗目标符合老年人的价值观。因此，本综述的目的是评估老年抑郁症干预措施对功能限制的有效性。这项系统综述确定了 15 项随机对照试验，其中评估了不同干预措施对老年抑郁症患者功能限制的有效性。这些干预措施分为四类：心理干预、药物治疗、体育锻炼和协同护理。多组分和协同护理干预措施似乎对改善功能限制最有希望，特别是在初级保健和社区居住的老年抑郁症患者中。然而，在专门的精神保健研究方面，证据不足。
