Depression Interventions Among Racial and Ethnic Minority Older Adults: A Systematic Review Across 20 Years

Abstract

While there is strong evidence in support of geriatric depression treatments, much less is available with regard to older U.S. racial and ethnic minorities. The objectives of this review are to identify and appraise depression treatment studies tested with samples of U.S. racial and ethnic minority older adults. We include an appraisal of sociocultural adaptations made to the depression treatments in studies meeting our final criteria. Systematic search methods were utilized to identify research published between 1990 and 2010 that describe depression treatment outcomes for older adults by racial/ethnic group, or for samples of older adults that are primarily (i.e., >50%) racial/ethnic minorities. Twenty-three unduplicated articles included older adults and seven met all inclusion criteria. Favorable depression treatment effects were observed for older minorities across five studies based on diverse settings and varying levels of sociocultural adaptations. The effectiveness of depression care remains mixed although collaborative or integrated care shows promise for African Americans and Latinos. The degree to which the findings generalize to non-English-speaking, low acculturated, and low income older persons, and to other older minority groups (i.e., Asian and Pacific Islanders, and American Indian and Alaska Natives) remains unclear. Given the high disease burden among older minorities with depression, it is imperative to provide timely, accessible, and effective depression treatments. Increasing their participation in behavioral health research should be a national priority.

Mediators of the impact of a home-based intervention (beat the blues) on depressive symptoms among older African Americans.

“…A systematic review of 23 effective models revealed that most were multi-component and included care management and a behavioral approach such as problem solving, cognitive behavioral or behavioral activation therapies, addressed unmet needs and provided participants specific skills to cognitively reframe and manage situational stressors such as poor health, housing or social needs (Gitlin, in press). These models are unified in their attempts to identify and tackle the multiple contextual factors that may contribute to or reinforce poor mood and which drug treatments cannot address (Frederick et al, 2007; Fuentes & Aranda, 2012; Gitlin, in press). …”

Association of Depressive Symptomatology with Receipt of Informal Caregiving Among Older American Indians: The Native Elder Care Study

“…Similarly, little is known about the effectiveness of depression treatment interventions among older American Indians. 57 Future studies are warranted to evaluate the impact of existing depression treatments in this population.…”

Ethics and Community Involvement in Syntheses Concerning American Indian, Alaska Native, or Native Hawaiian Health: A Systematic Review

“…Specifically, we excluded studies not focused on AI/AN/NH health that found no AI/AN/NH literature and made no assertions about AI/AN/NH populations (Fuentes and Aranda 2012; Jaja et al 2008; Park and Taylor 2007). We also excluded others not focused on AI/AN/NH health that found AI/AN/NH literature but did not discuss it in the AI/AN/NH context, did not present the AI/AN/NH results separately, and drew no AI/AN/NH-specific inferences (Herbst et al 2005).…”