title: Depressive symptoms and suicidal ideation among older adults receiving home delivered meals.
abstract: OBJECTIVE
  Homebound older adults may be vulnerable to the deleterious impact of untreated depression. Yet because these elders are difficult to reach, there is little data on the rates of depressive symptoms and suicidal ideation among this group. The objective of this study is to document the rates of depression and correlates among a population of homebound elders.
  
  
  METHODS
  Using a community based participatory research partnership, we implemented a routine screening for depressive symptoms and suicidal ideation among older recipients of Westchester County's home meal program. Older adults enrolled in the home delivered meal program were administered the Physician Health Questionnaire-9 (PHQ-9), and questions to assess pain, falls, alcohol abuse and perceived emotional distress.
  
  
  RESULTS
  In our sample of 403 meal recipients, 12.2% of older adults reported clinically significant depression (PHQ-9 > 9) and 13.4% reported suicidal thoughts. One-third of recipients with significant depressive symptoms were currently taking an antidepressant. Almost one-third of older adults who endorsed suicide ideation did not report clinically significant depressive symptoms. Among men, suicidal thoughts were associated with chronic pain and greater depression severity, whereas pain was not a predictor of suicidal thoughts among women.
  
  
  CONCLUSIONS
  More than one in nine elders suffer from depression; most are untreated with one-third undertreated. Through partnerships between public agencies that provide age related services and academic investigators there is an opportunity for improved detection of unmet mental health needs. Future research should explore innovative models to improve access to mental health services once unmet need is detected.
authors.affiliation: Department of Psychiatry, Weill Medical College of Cornell University, Whit Plains, NY 10605, USA. jsirey@med.cornell.edu
authors.forename: Jo Anne
authors.initials: JA
authors.lastname: Sirey
authors.forename: Martha L
authors.initials: ML
authors.lastname: Bruce
authors.forename: Mae
authors.initials: M
authors.lastname: Carpenter
authors.forename: Diane
authors.initials: D
authors.lastname: Booker
authors.forename: M Carrington
authors.initials: MC
authors.lastname: Reid
authors.forename: Kerry-Ann
authors.initials: KA
authors.lastname: Newell
authors.forename: George S
authors.initials: GS
authors.lastname: Alexopoulos
mesh_terms: D000369:Aged, 80 and over; D055812:Community-Based Participatory Research; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology*; D006233:Persons with Disabilities; D005260:Female; D005522:Food Services; D006801:Humans; D008297:Male; D010146:Pain / Q000523:psychology*; D016728:Self-Injurious Behavior / Q000517:prevention & control / Q000523:psychology*; D012944:Social Support; D012959:Socioeconomic Factors; D013405:Suicide / Q000523:psychology*; D011795:Surveys and Questionnaires; D000092864:Suicide Prevention