Centre for Emotional Health - Ageing Research Viviana Wuthrich

1. Centre for Emotional Health - Ageing ResearchViviana Wuthrich

2. Centre for Emotional Health (CEH) • Centre for research excellence • Focused on the understanding, treatment and prevention of anxiety, depression and related mental health problems • The Centre for Emotional Health also encompasses the Emotional Health Clinic and the eCentreClinic

3. Current members & Output • 11 Academic staff • 6 Post-doctoral research fellows • Around 65 doctoral students • Total research funding > $8.5M. (2010 – 2014) • Scientific publications > 115 (2010 – 2011)

4. Emotional Health Clinic • Highly respected clinical treatment service that provides the latest help for people suffering emotional difficulties. • Provides treatment and assessment services to around 500+ clients per year • Strong reputation among public and professionals • Around 30 students & 10 professional visitors each year

5. Agenda • Prevalence of anxiety and depression • Common signs of anxiety and depression in older adults • Consequence of these problems being left untreated • Latest findings regarding treatment of these problems in older adults

6. Ageing Population • ABS estimations for over 65 year olds: • 2004 = 13% (or 2.6 million) • 2051 = 26% • Estimation for over 85 year olds: • 2007 = 1.6% • 2051 = 5-7%

7. Mental Health Research is Neglected in Older Adults • Apart from Dementia • Little research exists into the understanding and treatment of anxiety and depression in older adults • There is more research for depression, very few studies focus on anxiety in older adults

8. Prevalence of Anxiety & Depression in Adults over 60 • Prevalence of clinical anxiety disorders is up to 10.2% • 24% for clinical depression in adults • Rates of clinical disorders for anxiety and depression decrease in older adulthood

9. 12 month prevalence of anxiety and depression by age group (NSMHW, 2007)

10. Lower Prevalence Rates • Prevalence may be underestimated: • Tools used to measure are unsuitable • Older adults less willing to admit symptoms • Symptoms change as people age • Better coping skills -wisdom and life experience

11. Prevalence of Mild Anxiety & Depression • Rates of subclinical depression are as high as 25% in primary health care settings, 50% in nursing homes • Rates of subclinical anxiety up to 5-30%

12. Consequences of Untreated Symptoms • Life dissatisfaction • Disability • Mortality • Medication • Health care services • Suicide • Dementia

13. Completed Suicide (ABS, 2010)

14. Symptoms of Depression • Sadness, tearfulness – but this is less prominent than in younger samples • Loss of interest • Low motivation • Hopelessness • Excessive fatigue • Difficulty sleeping

15. Reduced Levels of Sadness • Unclear why this is. Hypotheses include: • Less willing to admit low mood • Less able to recognise it • Depression characterised by hopelessness and helplessness rather than sadness • Biological changes or vascular lesions might result in differences in symptoms presentation

16. Symptoms of Anxiety • Anxiety most characterised by worry • Worry about relationships, health, finances, family • Restlessness or agitation • Difficulty sleeping • Other anxiety is less common (post traumatic stress, social anxiety, obsessive compulsive disorder)

17. Common Themes of Distress • Life long anxiety and/or depression • Relationship conflict • Worry about family, children and grandchildren • Burden of caring for frail parents or spouse • Worry: ageing, illness, dementia, fitness, finances • Difficulty adjusting to retirement, loss of purpose • Bereavement • Isolation, loss of social networks

18. Help Seeking- NSMHW (2007) • Of those people who identified as having anxiety or depression, service use was lowest among the young people (23%) and older adults aged 75-85years (23%) • Males were particularly unlikely to seek help across all age groups

19. Treatment for Anxiety & Depression • Most common treatments are medications • Possible side-effects, drug-to-drug interactions • Psychological treatments are also effective • International research indicates that psychological techniques can greatly benefit older adults • Problem solving skills, relaxation, changing negative thinking, socialising and discussion groups are all helpful

20. Treatment continued • Research normally is targeted at anxiety OR depression • Anxiety and depression commonly co-occur throughout the lifespan • Community sample in Netherlands aged 55-85 yrs comorbid prevalence of major depression and any anxiety disorder was 47.5% • Some research indicates that having both reduces the effectiveness of treating the other disorder

21. Our Research • Assessment of anxiety and depression in older adults • Symptom profiles • Emotion regulation • Coping skills • Barriers to treatment seeking • Psychological Treatments • Impact of cognitive changes on effectiveness of psychological treatments

22. Recent Trial (2007-2010) • Developed and examined the effectiveness of a group psychological treatment for comorbid anxiety and depression in adults over 60 • Compared to doing nothing, we found that psychological treatment provided benefits for both anxiety and depression symptoms and improved quality of life • These improvements were lasting (evident 3 months later)

23. Changes in Depression Score

24. Latest Research • Comparing two different psychological treatments to determine which is the most effective (randomised controlled trial) • Comorbid anxiety and depression in older adults aged 60 and over • Examining changes in symptom severity, quality of life, and cognitive performance • 3 year trial funded by National Health & Medical Research Council (2011-2013)

25. Contact Details • Further information about the free group treatment program for treating anxiety and depression in adults over 60 is available by contacting the Emotional Health Clinic on 9850 -8711 • Information on the Centre for Emotional Health is available at www.centreforemotionalhealth.com.au