Factors associated with antidepressant treatment in residential care: changes between 1990 and 1997

Background Depression is common among older people living in residential and nursing homes. Detection and treatment of late life depression may be sub-optimal in these settings. Aim To report the changes in, and factors associated with, antidepressant use among residents in care homes, in 1990 and 1997. Method Censuses of those aged 65 years and over in any type of residential care in the county of Leicestershire, UK, on 27 November 1990 and 30 November 1997. Care staff were asked to complete an assessment form for each resident Which included a rating of depression and use of antidepressants. Results The use of antidepressants increased from 11% (484/4415) in 1990 to 18.9% (777/4111) in 1997. Severity of depression as assessed by care staff, gender, younger age, better cognitive functioning, and use of other medications were consistently associated with antidepressant treatment. Antidepressant use was associated with better physical functioning (p = 0.00 1) in 1990 and frequency of falls in 1997 (p = 0.044). Conclusions Increased use of antidepressants appears to be due to the wider ran cc of antidepressant drugs available since 1990. However there is a need for better methods for care staff to detect depression in residents, and for appropriate action to be taken by those responsible for their medical management. Copyright (C) 2002 John Wiley Sons, Ltd.