Gesundheitswesen 2016; 78 - A65
DOI: 10.1055/s-0036-1586575

Unmet needs in the depressed primary care elderly and their relation to severity of depression: Results from the AgeMooDe study

S Alltag 1, J Stein 1, A Pabst 1, S Weyerer 2, W Maier 3, M Scherer 4, B Wiese 5, HH König 6, SG Riedel-Heller 1
  • 1Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig
  • 2Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim
  • 3Department of Psychiatry, University of Bonn and German Center for Neurodegenerative Diseases within the Helmholtz Association, Bonn
  • 4Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg
  • 5Institute for General Practice, Working Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover
  • 6Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Centre Hamburg-Eppendorf, University of Hamburg, Hamburg

Background: Depression is one of the most common diseases in the elderly population with serious consequences for daily functioning, quality of life and health services utilization. Research indicates that late-life depression is associated with specific care needs. Undetected or unmet care needs in the oldest old suffering from depression are expected to have a negative impact on successful treatment and effective health care provision.

Objectives: This study aims at examining the distribution of unmet environmental, physical, social and psychological care needs in a sample of the oldest old primary care patients with different levels of depression severity. Furthermore, the objective of this study was to analyze the association between specific unmet care needs and severity of depression.

Method: Data stems from the German multicentre study “Late-life depression in primary care: needs, health care utilization and costs (AgeMooDe)”. The sample consisted of 202 primary care patients aged 75 years and older suffering from depression. Patients were assessed via structured clinical interviews containing the German version of the Camberwell Assessment of Need for the Elderly (CANE) and the Hospital Anxiety and Depression Scale (HADS). Descriptive statistics, Spearman correlation coefficients and binary logistic regression analyses were computed.

Results: Patients with different levels of depression severity mostly reported physical and social unmet needs. Unmet environmental, social and psychological care needs showed significant positive linear correlation with different levels of depression severity. While unmet psychological care needs and severity of depression showed the strongest positive linear correlation, there was no significant correlation observed between unmet physical needs and depression severity. The binary regression analysis revealed that total unmet needs on the one hand and psychological unmet needs as a single predictor were significantly associated with increasing levels of depression severity.

Discussion: Unmet psychological needs were most strongly associated with depression severity in the oldest old primary care patients in Germany. This study contributed to a wider understanding of the relationship between unmet needs and depression in old age.

Implications for practice: Systematic needs assessment may play a crucial role in the course of prevention and effective treatment of late-life depression in the primary care context.