It is not unusual for older people to suffer with comorbid conditions. Arthritis and depression are among the more common health problems for elderly people. Approximately one insix older Americans suffer from depression, while degenerative joint disease affects four out of five who are past age 70.
A study in The Journal of the American Medical Association (2003;290:2428-2429) assessed whether intensifying the treatment for depression served also to improve the level of pain and function in older adults suffering with both depression and arthritis.
The Study
IMPACT (Improving Mood-Promoting Access to Collaborative Treatment) was a randomized, controlled trial performed from July 1999 to August 2001 at 18 primary care clinics from 8 health care organizations in 5 states. There were 1801 depressed adults, 60 years of age or older, who participated in the trial. 1001 of the participants (56%) reported coexisting arthritis when first evaluated at the onset of the study.
Antidepressant medications and/or 6 to 8 sessions of psychotherapy were randomly assigned to the trial participants. At baseline, 3, 6, and 12 months, the participants were assessed for:
- depression
- pain intensity (scale 0 to 10)
- interference with daily activities due to arthritis (scale 0 to 10)
- general health status
- overall quality-of-life outcomes
Results
Participants who were treated for depression with medications and psychotherapy showed fewer symptoms of depression after one year, and their arthritis symptoms improved also. Results showed the participants had less pain and less interference with daily activities due to arthritis. General health status and quality-of-life also improved.
This study was the first to analyze the effect of depression treatment on arthritis. The added benefit was unexpected and encouraging.
Sources:
Effect of Improving Depression Care on Pain and Functional Outcomes Among Older Adults With Arthritis, JAMA, (2003;290:2428-2429)
Depression treatment may ease arthritis, CNN.com, 11/11/2003
