Evidence-based practices in geriatric mental health care: an overview of systematic reviews and meta-analyses.
At least 20% of people over the age of 65 suffer from mental disorders. It is anticipated that the number of older Americans with psychiatric disorders will double over the next 30 years. There is, however, substantial unmet need. The recent Surgeon General's Report on Mental Health, a Report on Mental Health from the Administration on Aging, and an expert consensus statement underscore the need to plan for the challenge of providing services for elderly people with major mental disorders. Among the greatest challenges is the expertise gap that affects clinicians practicing in routine clinical settings. This gap reflects inadequate training in geriatrics and a failure to incorporate contemporary clinical research findings and known evidence-based practices (EBPs) into usual care. This article provides an overview of the emerging evidence-base supporting the efficacy of empirically-validated geriatric mental health interventions for major geriatric mental health disorders, including systematic EBP reviews, meta-analytic studies, and expert consensus statements. Cautions and limitations regarding the reliance on randomized, controlled trials, meta-analyses, and systematic reviews also are presented.
Bartels
Stephen J
SJ
Department of Psychiatry, Dartmouth Medical School, One Medical Center Drive, Lebanon, NH 03756, USA. stephen.j.bartels@dartmouth.edu
Dums
Aricca R
AR
Oxman
Thomas E
TE
Schneider
Lon S
LS
Areán
Patricia A
PA
Alexopoulos
George S
GS
Jeste
Dilip V
DV
D000368:Aged; D003863:Depression / Q000628:therapy; D019317:Evidence-Based Medicine; D005852:Geriatric Psychiatry / Q000193:education / Q000592:standards*; D006299:Health Services for the Aged / Q000592:standards*; D006801:Humans; D008605:Mental Health Services / Q000592:standards*; D010818:Practice Patterns, Physicians'; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D014481:United States
D017367:Selective Serotonin Reuptake Inhibitors