Increased prescribing has little effect on depression levels in care homes

Use of antidepressants in care homes has quadrupled over the past two decades, but has had no effect on levels of depression, new research has concluded.

According to a study by the Universities of Cambridge and East Anglia dating from 1991-2011, antidepressant use in care homes has risen from 7.4 per cent to 29.2 per cent, although the prevalence of depression in care homes remains unchanged at around one in ten residents.

The findings have prompted lead study author Prof Antony Arthur, from UEA’s School of Health Sciences, to call for healthcare professionals to take a wider view of the management of depression. He said: “The causes of depression in older people, the factors that perpetuate it, and the best ways to manage it remain poorly understood and merit more attention.”  

The findings are based on the Cognitive Function and Ageing Studies, conducted at two time points – between 1991 and 1993, and between 2008 and 2011.  Researchers interviewed more than 15,000 over 65s in England and Wales to see whether the prevalence of depression and antidepressant use are changing.

The study’s lead investigator Prof Carol Brayne, director of the Cambridge Institute of Public Health, said: “This new work reveals that depression has not shown the same reduction even in the presence of dramatically increased prescribing, itself not without concern given potential adverse effects we have also shown that are associated with polypharmacy.”

Key findings

  • The proportion of older people receiving anti-depressant medication more than doubled over two decades – from 4.2 per cent in the early nineties to 10.7 per cent 20 years later.
  • The estimated prevalence of depression among over 65s in the early 1990s was 7.9 per cent, compared to 6.8 per cent 20 years later.
  • Depression and antidepressant use were more common in women than men at both time points. 
  • Depression was associated with living in a more deprived area.
  • Across both time periods, most people with case-level depression were not on antidepressants, while most of those on antidepressants did not have depression.
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