THE EFFECT OF PRIMARY-CARE NURSE INTERVENTION UPON OLDER-PEOPLE SCREENED AS DEPRESSED

Ninety-six older people were identified as probably suffering from pervasive depression by screening a household-enumerated population in Gospel Oak Ward, Inner London. They were further assessed by means of the GMS-AGECAT, and then randomly allocated to either the intervention of community nurse management or normal, local general practitioner care, There were difficulties in implementing recommended changes in the intervention group, in particular the introduction of antidepressant medication and attendance at day centre facilities. Despite these difficulties, an independent assessment 3 months later performed by an interviewer blind to intervention status found that the nurse-intervened group showed improved depression scores compared to controls. This effect seemed to be greater among the long-standing cases and was not associated with time spent or number of visits to the subject by the nurse. This community-based intervention study indicates that depression in older people can be helped by active interventions coordinated and implemented at the level of primary care.