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Mental & Emotional Health

The Aging Brain Care Medical Home Lowers Severity of Depression

The Aging Brain Care Medical Home, a novel brain-focused population health management program implemented in the homes of older adults, lowered depression severity by more than 50 percent over six months according to a November 2016 study from the Regenstrief Institute, Indiana University Center for Aging Research, IU Center for Health Innovation and Implementation Science, and Eskenazi Health. The research is published online in Clinical Interventions in Aging, a peer-reviewed open access journal.

A release from Indiana University notes that the ABC Medical Home program utilizes a trained and scalable workforce of care coordinator assistants with at least high school educations as the core of an interdisciplinary care team of nurses, social workers, and physicians responsible for meeting the complex biopsychosocial brain-care needs of older adults.

The implementation study provides strong evidence of the sustained effectiveness of the ABC Medical Home program at inducing depression remission employing a workforce that develops long-term relationships with the patients through home visits and telephone contacts.

The more than 50 percent decrease in depression symptoms occurred in individuals with high levels of these symptoms. While women experienced improvement sooner than men, there was no gender difference in symptom diminution at the end of six months.

In older adults with low levels of depression, depression scores remained low over time indicating that the care model prevented depression symptoms from recurring.

Michael LaMantia, M.D., MPH, first author of the new study, offers the following analogy to explain the different responses of older adults with high levels of depressive symptoms and those with low levels. “If you have people who are driving a car at 60 miles per hour, these drivers have a lot of room to decelerate over time because they are going at a high speed; similarly there is significant room for symptom decease in those with high symptom levels; but for those with low depressive symptom levels, like those drivers traveling 5 or 10 miles per hour, there isn’t a whole lot of decline possible. Keeping them from accelerating is the goal.”

“The heart of the ABC Medical Home model is collaborative care. We are working in conjunction with the primary care physicians to provide these patients the level of care that they need,” said Dr. LaMantia, a former Regenstrief Institute and IU Center for Aging Research investigator who recently became Section Head of Geriatric Medicine and associate professor of medicine at the University of Vermont College of Medicine.

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