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Functional improvement by behavioural activation for depressed older adults
Noortje P Janssen1,2,3, Richard C Oude Voshaar4, Sanne Wassink-Vossen5
1Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
Summary
Behavioural activation (BA) improved functional limitations in older adults with depression compared to treatment as usual (TAU). However, this effect diminished over time, particularly for those with cognitive impairment.
Area of Science:
- Gerontology
- Mental Health
- Primary Care Research
Background:
- Functional limitations impact recovery in older adults with depression.
- Collaborative care models show promise for improving functioning in this demographic.
- Behavioural activation (BA) is evaluated for its effectiveness in primary care settings.
Purpose of the Study:
- To assess the effectiveness of behavioural activation (BA) on functional limitations in older adults with depression.
- To compare BA with treatment as usual (TAU) in a primary care context.
- To examine the long-term effects of BA on functioning.
Main Methods:
- A multicentre cluster randomised controlled trial involving 59 primary care centres.
- 161 older adults (≥65 years) with depressive symptoms participated.
- An eight-week individual BA program was compared to TAU, with outcomes measured at 9 weeks and 12 months using the WHODAS 2.0.
Main Results:
- BA significantly reduced functional limitations post-treatment compared to TAU (difference -3.62, p=0.01).
- A medium effect size (0.39) was observed at 9 weeks, which decreased to a small, non-significant effect at 12 months (difference -2.22, p=0.14).
- Cognitive function (MoCA score) moderated the results, with benefits primarily seen in those without cognitive impairment.
Conclusions:
- Behavioural activation (BA) offers a faster improvement in functional limitations for depressed older adults without cognitive decline.
- The positive effects of BA on functioning diminish over a 12-month follow-up period.
- Further confirmatory research is necessary to validate these findings.
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