Management of Depression and Anxiety in Older Surgical Patients: Results from a Randomized Clinical Trial
Background
Depression and anxiety are prevalent among older adults undergoing surgery, with significant implications for postoperative outcomes. These mental health symptoms are associated with increased risks of complications such as delirium and delayed recovery. Current perioperative care models often inadequately address the mental health needs of this population, highlighting the importance of targeted interventions. Preoperative depression and anxiety symptoms are prevalent, estimated at 10% to 33% for depression and 22% for anxiety in the U.S.
Data Highlights
No numerical data is provided in the source material.
Key Findings
Preoperative depression and anxiety symptoms are prevalent in older surgical patients, with estimates ranging from 10% to 33% for depression and 22% for anxiety in the U.S.
The intervention developed integrated psychological management and pharmacologic optimization to address mental health needs.
Eligibility for the trials required participants to be at least 60 years old with clinically meaningful anxiety and/or depression symptoms.
Participants were screened using the Patient Health Questionnaire 4 (PHQ-4) and the PHQ-ADS scale for comprehensive assessment.
The study employed a hybrid type 1 effectiveness-implementation design to evaluate both the effectiveness and implementation potential of the intervention.
Clinical Implications
The findings suggest that addressing mental health in older surgical patients through structured interventions may improve postoperative outcomes. Clinicians should consider integrating psychological management and medication optimization in perioperative care for this demographic.
Conclusion
The study underscores the need for effective interventions targeting depression and anxiety in older surgical patients, which may enhance recovery and reduce complications.
by Joanna Abraham, Katherine J. Holzer, Simon Haroutounian, Bethany Pennington, Ana Baumann, Ryan Calfee, Theresa Cordner, Kenneth E. Freedland, Thomas Kannampallil, Benjamin Kozower, Emily Lenard, J Philip Miller, Mary Politi, Michael Yingling, Michael S. Avidan, Eric J. Lenze
