Message-based psychotherapy for older adults: A cohort comparison study.

Area of Science:

• Digital Mental Health
• Geriatric Psychiatry
• Telemedicine

Background:

• Digital Mental Health Interventions (DMHI) can reduce mental health care disparities.
• Older adults may face barriers to DMHI access, including technology and awareness gaps.
• Understanding engagement and outcomes in older adults using DMHI is crucial.

Purpose of the Study:

• To compare longitudinal treatment engagement patterns in older versus younger adults using DMHI.
• To examine 15-week clinical outcomes for depression and anxiety in these age groups.
• To assess the efficacy of asynchronous telemedicine for older adults with mental health needs.

Main Methods:

• 2,470 older adults (55+) and matched younger adults (26-35) with depression/anxiety were treated via messaging.
• Engagement metrics included days in treatment, active messaging, and message/word volume.
• Symptom changes were tracked using PHQ-9 and GAD-7 over 15 weeks.

Main Results:

• Older adults had longer treatment duration but similar active engagement (messages, words) as younger adults.
• Both age groups showed comparable final symptom reduction in depression and anxiety, controlling for treatment length.
• Younger adults experienced faster anxiety symptom reduction, but not depression, compared to older adults.

Conclusions:

• Older adults demonstrate comparable engagement and symptom improvement to younger adults in DMHI.
• Message-based telemedicine is a viable option for treating older adults with depression and anxiety.
• These findings support DMHI as a scalable solution for future mental healthcare demands.