Behavioral activation for the treatment of depression in older adults. A randomised controlled multicenter trial in primary care, DepActive

Depression affects between 5-15% of adults ≥ 65-years in Sweden.

Depression in older adults reduces functional ability and quality of life, and increases the risk for morbidity, loneliness, and suicide.

Psychological treatment is recommended as a first-line treatment for depression, which about 3% of older adults with depression in Sweden report receiving.

One effective psychological treatment is Behavioral activation, which reduces depressive symptoms by increasing enjoyable, meaningful and important activities, for example exercise and social activities.

The research group conducted a pilot study of telephone-based behavioral activation for isolated older adults with depression during the covid-19 pandemic.

The intervention consisted of four telephone calls, and the results showed a significant decrease in depressive symptoms, with maintained effects for six months.

Now, we wish to build upon this pilot trial, and conduct a larger trial with the aim to investigate if telephone-based behavioral activation is an effective treatment for depression in older adults in a primary care context.Data and methods: A randomized controlled multi center study with self-rated depressive symptoms as primary outcome measure.

Secondary outcome measures include depression diagnosis, activity level (self-rated and measured with accelerometer), cognitive functions, utilization of community services, cost effectiveness, and self-rated anxiety, daily functioning, quality of life, self-efficacy, loneliness, and experience of person centered care.Relevance and benefits: Depression in older adults is a global healthcare challenge, and there is a great need for effective, scalable psychological treatments.

Behavioral activation is one such treatment, and remote-delivery by telephone increases the accessibility.

The treatment is manual-based and can be delivered by several healthcare professions.Implementation: A primary care study in the regions of Västmanland, Sörmland and Örebro in Sweden, aiming to investigate the effect of telephone-based behavioral activation for the treatment of depression in older adults.

The research group has representatives from each region, and the research is affiliated to Uppsala university and Örebro university. The project is co-created with representatives from the primary care organisations and a patient representative.

The grant will be used for salary for the principal investigator, PhD-students, supervisors, and the patient representative.