Data-driven subtypes of late-life depression-secondary analysis of a cluster-randomized RCT.

IF 2.8 3区医学 Q3 GERIATRICS & GERONTOLOGY

Aging & Mental Health Pub Date : 2025-02-23 DOI:10.1080/13607863.2025.2468406

Judith van Diepen, Gert-Jan Hendriks, Marij Zuidersma, Richard Oude Voshaar, Noortje Janssen

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引用次数: 0

Abstract

Objectives: Cognitive performance varies among depressed older patients and is known to affect treatment outcome. We used a data-driven approach to create subtypes of late-life depression and exploratively visualized the course of depression during either behavioural activation (BA) or treatment as usual (TAU).

Method: Among 161 depressed (PHQ ≥ 10) older (≥65 years) participants of a cluster randomized controlled trial in primary care (NL5436), we performed latent class analysis (LCA) on individual depressive symptoms and performance on several cognitive tests. The course of depressive symptoms during treatment was plotted to explore whether differences between the classes differed between BA and TAU.

Results: Five classes best fitted the data: (1) mild depression without cognitive deficits, (2) moderate depression with insomnia and cognitive deficits, (3) severe depression with cognitive deficits, (4) moderately severe depression with hypersomnia and cognitive deficits, and (5) moderately severe depression with cognitive-affective symptoms but no cognitive deficits. Graphs showed that depressive symptoms of subgroups with severe depressive symptoms improved more during BA compared to TAU, regardless of cognitive deficits.

Conclusions: We identified five subgroups. Graphs suggest that effectiveness of BA is similar across all subgroups, whereas TAU seems less effective in the more severely depressed subgroups. Replication is warranted.

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来源期刊

Aging & Mental Health 医学-精神病学

CiteScore

7.00

自引率

2.90%

发文量

176

审稿时长

4-8 weeks

期刊介绍： Aging & Mental Health provides a leading international forum for the rapidly expanding field which investigates the relationship between the aging process and mental health. The journal addresses the mental changes associated with normal and abnormal or pathological aging, as well as the psychological and psychiatric problems of the aging population. The journal also has a strong commitment to interdisciplinary and innovative approaches that explore new topics and methods. Aging & Mental Health covers the biological, psychological and social aspects of aging as they relate to mental health. In particular it encourages an integrated approach for examining various biopsychosocial processes and etiological factors associated with psychological changes in the elderly. It also emphasizes the various strategies, therapies and services which may be directed at improving the mental health of the elderly and their families. In this way the journal promotes a strong alliance among the theoretical, experimental and applied sciences across a range of issues affecting mental health and aging. The emphasis of the journal is on rigorous quantitative, and qualitative, research and, high quality innovative studies on emerging topics.