New England Geriatric Research, Education, and Clinical Center, VA Bedford Healthcare System, Bedford, Massachusetts, USA.
Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
Gerontologist. 2024 Apr 1;64(4). doi: 10.1093/geront/gnad046.
Scalable, transdiagnostic interventions are needed to meet the needs of a growing population of older adults experiencing multimorbidity and functional decline. Behavioral activation (BA) is a pragmatic, empirically supported treatment for depression that focuses on increasing engagement in values-aligned activities. We propose BA is an ideal transdiagnostic intervention approach for older adults because it (a) specifically targets activity restriction, a shared characteristic of common conditions of aging; and (b) has strong potential for scalability through delivery by a broad range of clinician and nonclinician interventionists and via telehealth. We describe the history of BA and review recent literature demonstrating impacts beyond depression including on cognition, social isolation, and disability. We also describe the feasibility of delivering BA across interventionists, settings, and modalities. Our approach advances scholarship by proposing BA as a scalable, transdiagnostic behavioral intervention to address functional decline in older adults with common geriatric conditions.
需要可扩展的、跨诊断的干预措施来满足越来越多的患有多种疾病和功能下降的老年人群体的需求。行为激活（BA）是一种实用的、有经验支持的治疗抑郁症的方法，侧重于增加与价值观一致的活动的参与度。我们提出 BA 是一种理想的跨诊断干预方法，适用于老年人，因为它：（a）专门针对活动限制，这是常见老年疾病的共同特征；（b）通过广泛的临床医生和非临床医生干预者以及通过远程医疗进行交付，具有很强的可扩展性潜力。我们描述了 BA 的历史，并回顾了最近的文献，这些文献表明其影响不仅限于抑郁症，还包括认知、社交隔离和残疾。我们还描述了在干预者、环境和模式之间提供 BA 的可行性。我们的方法通过提出 BA 作为一种可扩展的、跨诊断的行为干预措施，为解决常见老年疾病患者的功能下降问题提供了学术进展。
