Impact of Collaborative Care on Depression in Patients Aged 60+: A Secondary Analysis of the GermanIMPACT Study on Behavioural Activation
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Sample
2.2. Measures
2.3. Statistical Analyses
3. Results
3.1. Improvement in the PHQ-9 Total Score
3.2. Deterioration of the PHQ Total Score After 12 Months
4. Discussion
4.1. Strengths and Limitation
4.2. Implications
- Self-care and spirituality: individually planned
- Daily duties: maintain a personal daily routine
- Physical activity: individually planned
- Social activities: consider personal interaction with others
- Excursions and travel: consider planning alternatives
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Category | Intervention Group, N = 136 Patients |
---|---|
Gender | |
Female, n (%) | 106 (78%) |
Male, n (%) | 30 (22%) |
Mean age, (range) | 71 years (52–88) |
Living alone, (%) | 51.5% |
Level of education, (%) | |
Completed university degree | 12.5% |
University entrance qualification | 9.6% |
Secondary school certificate | 51.5% |
Intermediate school certificate | 22.8% |
Other or no educational qualification | 3.6% |
Employment, (%) | |
Still employed | 10.3% |
Retired | 65.4% |
Housewife/househusband | 14.0% |
Unemployed | 3.7% |
Other or missing | 6.6% |
Sufficient financial resources (Subjective patient assessment), (%) | |
Yes | 48.9% |
Partially | 39.3% |
No | 11.9% |
Activity Category | Examples | Relative Frequency | N |
---|---|---|---|
Physical | “Go to the gym twice a week” | 15.9% | 347 |
Daily duties | “Cook food” “Do the laundry” | 13.3% | 290 |
Social | “Visiting relatives”, “Activity at the senior citizens’ meeting place” | 12.4% | 272 |
IMPACT related | “Fill out daily logs” “View activity list” | 10.8% | 237 |
At rest | “Listen to the radio” “Read a book” | 10.3% | 225 |
Organizational | “Plan the sale of your apartment” “Organize household help” | 9.5% | 207 |
Excursions and travel | “Holiday in ‘X’ with husband” “Trip by bus” | 8.5% | 186 |
Self-care and spiritual | “Meditate daily” “Go to church on Christmas Eve” | 8.4% | 183 |
Health care | “Make an appointment with an orthopaedist” “Get a prescription from your GP” | 5.2% | 113 |
Culture and education | “Attend a lecture on topic ‘X’” “Go to the theatre” | 3.4% | 75 |
Other | “Wants to cancel planned kale dinner” “Cemetery visits: ‘X’th anniversary of the husband’s death” | 2.4% | 53 |
Activity Category | Successful | Not Implemented | Partial/Unknown/Activity Replaced |
---|---|---|---|
Daily duties | 76.9% (223) | 15.5% (45) | 7.6% (22) |
At rest | 73.3% (165) | 20.0% (45) | 6.7% (15) |
Social | 71.0% (193) | 24.3% (66) | 4.8% (13) |
Culture and education | 70.7% (53) | 21.3% (16) | 8.0% (6) |
Physical | 70.6% (245) | 18.7% (65) | 10.6% (37) |
Self-care and spiritual | 69.4% (127) | 21.9% (40) | 8.7% (16) |
Other | 67.9% (36) | 28.3% (15) | 3.8% (2) |
Excursions and travel | 65.1% (121) | 30.6% (57) | 4.3% (8) |
Organizational | 52.7% (109) | 40.1% (83) | 6.2% (15) |
Health care | 51.3% (58) | 37.2% (42) | 11.6% (13) |
IMPACT related | 47.7% (113) | 41.8% (99) | 10.6% (25) |
Total | 66.0% (1443) | 26.2% (573) | 7.8% (172) |
Activity Category 1 | B | SE | Wald | p-Value | Odds Ratio (95% CI) |
---|---|---|---|---|---|
IMPACT-related | 0.278 | 0.295 | 0.887 | 0.346 | 1.321 (0.740–2.355) |
Social | −0.102 | 0.096 | 1.137 | 0.286 | 0.903 (0.748–1.089) |
At rest | 0.106 | 0.135 | 0.617 | 0.432 | 1.122 (0.854–1.447) |
Self-care and spiritual | 0.432 | 0.218 | 3.925 | 0.048 | 1.540 (1.005–2.360) |
Daily duties | 0.207 | 0.141 | 2.151 | 0.143 | 1.230 (0.933–1.622) |
Organizational tasks | −0.196 | 0.160 | 1.503 | 0.220 | 0.822 (0.600–1.125) |
Physical | 0.057 | 0.100 | 0.319 | 0.572 | 1.058 (0.869–1.288) |
Health care | −0.167 | 0.173 | 0.932 | 0.334 | 0.846 (0.602–1.188) |
Culture and education | −0.028 | 0.177 | 0.025 | 0.875 | 0.973 (0.688–1.376) |
Excursions and travel | 0.223 | 0.176 | 1.610 | 0.205 | 1.250 (0.885–1.765) |
Age | −0.018 | 0.031 | 0.353 | 0.553 | 0.982 (0.925–1.043) |
Gender | 0.073 | 0.523 | 0.020 | 0.889 | 1.076 (0.386–2.996) |
Living situation | 0.074 | 0.453 | 0.026 | 0.871 | 1.076 (0.443–2.616) |
Baseline PHQ-9 | 0.160 | 0.049 | 10.491 | 0.001 | 1.173 (1.065–1.293) |
(Constant) | −0.636 | 2.312 | 0.076 | 0.783 | 0.530 |
Parameter | B | SE | Wald | p-Value | Odds Ratio (95% CI) |
---|---|---|---|---|---|
Sum of performed activities per patient | 0.069 | 0.025 | 7.891 | 0.005 | 1.071 (1.021–1.124) |
Gender | −0.054 | 0.486 | 0.012 | 0.912 | 0.947 (0.365–2.457) |
Age | −0.031 | 0.028 | 1.163 | 0.281 | 0.970 (0.917–1.025) |
Living situation | 0.024 | 0.404 | 0.004 | 0.952 | 1.025 (0.464–2.262) |
Baseline PHQ-9 | 0.152 | 0.044 | 11.759 | 0.001 | 1.165 (1.067–1.271) |
(Constant) | 0.451 | 2.120 | 0.045 | 0.831 | 1.571 |
Activity Category 1 | B | SE | Wald | p-Value | Odds Ratio (95% CI) |
---|---|---|---|---|---|
IMPACT-related | 0.518 | 0.237 | 4.771 | 0.029 | 1.679 (1.055–2.673) |
Social | 0.409 | 0.220 | 3.459 | 0.063 | 1.506 (0.978–2.318) |
At rest | 0.114 | 0.276 | 0.171 | 0.679 | 1.121 (0.653–1.924) |
Self-care and spiritual | 0.202 | 0.314 | 0.414 | 0.520 | 1.224 (0.661–2.265) |
Daily duties | 0.409 | 0.314 | 2.437 | 0.118 | 1.632 (0.882–3.020) |
Organizational tasks | −0.047 | 0.167 | 0.079 | 0.778 | 0.954 (0.687–1.324) |
Physical | 0.333 | 0.308 | 1.170 | 0.279 | 1.395 (0.763–2.550) |
Health care | 0.408 | 0.245 | 2.762 | 0.097 | 1.504 (0.929–2.433) |
Culture and education | 0.532 | 0.567 | 0.880 | 0.348 | 1.702 (0.560–5.168) |
Excursions and travel | −0.869 | 0.451 | 3.709 | 0.054 | 0.419 (0.173–1.016) |
Age | 0.035 | 0.038 | 0.830 | 0.362 | 1.036 (0.961–1.117) |
Gender | 0.509 | 0.626 | 0.663 | 0.416 | 1.664 (0.488–5.670) |
Living situation | 0.798 | 0.568 | 1.973 | 0.160 | 2.221 (0.729–6.764) |
Baseline PHQ-9 total score | −0.182 | 0.062 | 8.659 | 0.003 | 0.833 (0.738–0.941) |
(Constant) | −3.644 | 2.950 | 1.525 | 0.217 | 0.026 |
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Boczor, S.; Ashrafi, S.; Bjerregaard, F.; Bleich, C.; Grochtdreis, T.; Lühmann, D.; Härter, M.; Hölzel, L.; Hüll, M.; Tinsel, I.; et al. Impact of Collaborative Care on Depression in Patients Aged 60+: A Secondary Analysis of the GermanIMPACT Study on Behavioural Activation. Behav. Sci. 2025, 15, 462. https://doi.org/10.3390/bs15040462
Boczor S, Ashrafi S, Bjerregaard F, Bleich C, Grochtdreis T, Lühmann D, Härter M, Hölzel L, Hüll M, Tinsel I, et al. Impact of Collaborative Care on Depression in Patients Aged 60+: A Secondary Analysis of the GermanIMPACT Study on Behavioural Activation. Behavioral Sciences. 2025; 15(4):462. https://doi.org/10.3390/bs15040462
Chicago/Turabian StyleBoczor, Sigrid, Sanaz Ashrafi, Frederike Bjerregaard, Christiane Bleich, Thomas Grochtdreis, Dagmar Lühmann, Martin Härter, Lars Hölzel, Michael Hüll, Iris Tinsel, and et al. 2025. "Impact of Collaborative Care on Depression in Patients Aged 60+: A Secondary Analysis of the GermanIMPACT Study on Behavioural Activation" Behavioral Sciences 15, no. 4: 462. https://doi.org/10.3390/bs15040462
APA StyleBoczor, S., Ashrafi, S., Bjerregaard, F., Bleich, C., Grochtdreis, T., Lühmann, D., Härter, M., Hölzel, L., Hüll, M., Tinsel, I., Scherer, M., & Kloppe, T. (2025). Impact of Collaborative Care on Depression in Patients Aged 60+: A Secondary Analysis of the GermanIMPACT Study on Behavioural Activation. Behavioral Sciences, 15(4), 462. https://doi.org/10.3390/bs15040462