title: No longer undertreated? Depression diagnosis and antidepressant therapy in elderly long-stay nursing home residents, 1999 to 2007.
abstract: OBJECTIVE
  To examine the evolution of depression identification and use of antidepressants in elderly long-stay nursing home residents from 1999 through 2007 and the associated sociodemographic and facility characteristics.
  
  
  METHODS
  Annual cross-sectional analysis of merged resident assessment data from the Minimum Data Set (MDS) and facility characteristics from the Online Survey Certification and Reporting data.
  
  
  METHODS
  Nursing homes in eight states (5,445 facilities).
  
  
  METHODS
  Long-stay nursing home residents aged 65 and older (2,564,687 assessments).
  
  
  METHODS
  Physician-documented depression diagnoses recorded in the MDS were used to identify residents with depression; antidepressant use was measured using MDS information about residents' receipt of an antidepressant in the 7 days before assessment.
  
  
  RESULTS
  Diagnosis of depression and antidepressant therapy in residents diagnosed increased at a rapid rate. By 2007, 51.8% of residents were diagnosed with depression, 82.8% of whom received an antidepressant. Adjusted odds of treatment were higher for younger residents, whites, and those with moderate impairment of cognitive function.
  
  
  CONCLUSIONS
  This study demonstrates striking increases in depression diagnosis and treatment with antidepressant medications, but disparities persist without clear evidence about underlying mechanisms. More research is needed to assess effectiveness of antidepressant prescribing.
authors.affiliation: Center for State Health Policy, Chronic Disease Management, and Outcomes, Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, New Jersey. dgaboda@ifh.rutgers.edu
authors.forename: Dorothy
authors.initials: D
authors.lastname: Gaboda
authors.forename: Judith
authors.initials: J
authors.lastname: Lucas
authors.forename: Michele
authors.initials: M
authors.lastname: Siegel
authors.forename: Ece
authors.initials: E
authors.lastname: Kalay
authors.forename: Stephen
authors.initials: S
authors.lastname: Crystal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003071:Cognition; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes; D011594:Psychometrics / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents