Depression care management prevents death among older adults with diabetes

According to a new study published in the Journal of the American Geriatrics Society, effective treatment for depression could go a long way toward improving health status and even preventing death among older adults who also have diabetes.

Researchers assessing depression care management--consisting of trained depression care managers working with physicians and older adults to offer recommendations and ensure follow-through on those suggestions--found that older people with diabetes who received structured depression care management were 53 percent less likely to die over the course of the study when compared with people who received care as usual. The researchers concluded that depression care management also seemed to reduce the risk of death for people with other chronic conditions (except heart disease), but not to the same extent as what they saw with diabetes.

Depression has a number of effects on health, including changing how the body maintains balance and reacts to stress and making it harder for people to be physically active, engage in self-care, and follow through on treatment plans. While these risks have been known for some time, it has been less clear whether treating depression would translate into improvements in health.

In this new study, researchers evaluated 1,226 people over the age of 60 who had been diagnosed with major depression, minor depression, or no depression. Participants completed questionnaires about their health, including whether or not they had chronic diseases such as diabetes or heart disease.

In addition to the reduction in mortality, the study also found that the structured treatment improved depression considerably more than did care as usual. Forty percent of the participants experienced complete relief of depression symptoms after four months of treatment, compared to 22.5 percent of older people receiving care as usual.

As one of the first studies to examine if treating depression reduces the risk for death across chronic medical conditions, this work highlights the need to integrate mental health and primary care services. Doing so may end up saving lives as well as reducing the suffering produced by depression.