An Evidence-Based Treatment for Depression in the Elderly
The PEARLS Program was initially tested by the University of Washington using a randomized controlled trial in the community setting between 2000 and 2003. The main objective of this trial was to determine the effectiveness of the PEARLS Program as a treatment approach for managing minor depression or dysthymia in older adults living with social isolation, multiple chronic medical problems and physical impairment. The study evaluated the impact of the PEARLS Program on participants’ levels of depression, quality of life and healthcare utilization. Participants in the study were 138 clients aged 60 years or older who received care from community senior service agencies in metropolitan Seattle; just over half (51.4%) had minor depression and the remainder had dysthymia (48.6%). Half of all participants were randomly assigned to receive the PEARLS Program, and half were randomly assigned to continue with their usual medical care. This study showed that over 12 months, individuals who received the PEARLS Program were more likely than those who did not receive PEARLS to:
- Have a 50% or greater reduction in depression symptoms (43% of PEARLS recipients vs. 15% of the usual care group).
- Achieve complete remission from depression (36% of PEARLS recipients vs. 12% of the usual care group).
- Have greater health-related quality-of-life improvements in both functional and emotional well-being.
- The study also demonstrated a trend toward lower hospitalization rates among those who received the PEARLS Program compared to those who did not.
PEARLS participants were more likely to have a significant reduction in depression and an improvement in functional and emotional well-being.
Moreover, the PEARLS Program study findings also support a model for community-based organizations to screen and effectively treat depressed, frail older adults using primarily non-pharmacological methods.
The study was funded by the CDC and conducted as a collaboration between staff and faculty members from the University of Washington’s HPRC and managing, supervisory and clinical staff at Aging and Disability Services (ADS, the Seattle/King County Area Agency on Aging) and Senior Services of Seattle/King County. Because this collaboration began at the outset, the PEARLS Program was designed to take into account the “real world” framework and challenges – such as staffing, data management and other program priorities – that may arise during implementation of the PEARLS Program in a community organization.