PICO question, Depression within the elderly Health, Medicine Essay

Pico Question, Depression in the Elderly
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Pico Question, Depression in the Elderly
Part I: Overview
Although depression is not a common disorder among the elderly compared to younger people, it has serious implications. While suicide cases related to depression among older adults have declined significantly, this population is at higher risk of suffering from this disorder compared to younger individuals. Nevertheless, older patients rarely exhibit affective symptoms and only display somatic symptoms, cognitive changes, and decreased interest in various things. Consequently, due to the lack of exhibition of affective symptoms among the elderly, the cases of depression may go unnoticed and untreated despite being higher in nursing homes. The lifestyle, experiences, and preferences of older adults are different from those of younger adults. For example, older individuals are prone to harmful falls and loneliness, which are experiences that can lead to depression. In addition, older persons are less expectant of finding a purpose in life and are more likely to stop looking for new sources of purpose. Consequently, a feeling of hopelessness may ensue. A hopeless, lonely, and fearful person has a higher likelihood of developing depression, which indicates that even older adults can suffer from depression too. Nonetheless, depression mostly affects older adults residing in nursing homes than those living in their homes. Approximately 20.3% of elderly patients living in nursing homes suffer from major depression (McCarthy-Zelaya, 2016). The rate could be higher if cases of subsyndromal depression are taken into account. Subsyndromal depression refers to a condition where symptoms of depression are present but are not severe enough to be regarded as minor or major depression. It is crucial for care providers, including nurses, to formulate effective strategies for managing depression among elderly patients, particularly those living in nursing homes. Formulating effective depression management strategies is crucial as it will help the care providers to compensate for the difficulties of diagnosing the condition among the elderly population. The PICO question of the current study is; in older adults with depression living nursing homes, is physical exercise effective compared to anti-depressant medications in the management of depression?
Population: Older adults living with depression
Intervention: Physical exercise
Comparison: Anti-depressant medications
Outcome: Effective management of depression
Part II: Search Strategy
Step 1: Research Tools
For the current study, different tools, including electronic databases such as Medline, PubMed, NCBI, OMIM, PMC, Cochrane Library, EMBASE, Google Scholar, Journal of Gerontology, and The Journal of the American Association were used to search for relevant sources required to complete this assignment.
Step 2: Keywords, Terms, and Criteria
Various keywords and phrases were entered into the search engines of the databases mentioned previously to generate appropriate sources for the current study. They include
* Depression
* Exercising
* Exercising “and” elderly
* Depression “and” exercising
* “Depression management”
* Physical exercise “and” pharmacological interventions in depression management
* “Geriatric depression”
Inclusion Criteria for Sources
All sources used
* Are scholarly peer-reviewed
* Are not older than ten years
* Have information concerning physical exercise or pharmacological interventions in control of depression
* Contain elderly adults as population
* Contain first-hand information apart from one that is a systematic review study
* Are from reputable medical or other databases
Exclusion Criteria
* Population of individuals less than 60 years
* Published before 2010
* Lacked full text (only abstract present)
* Meta-analysis
Part III: Summary of Scholarly Articles
Minghelli et al. (2013) carried out research to determine the relationship between physical exercise and depression among older adults. The investigators recruited 72 older patients who were divided into groups depending on whether they practiced physical exercise or not. The first group consisted of 38 individuals who did not participate in exercising, whereas the other group contained 34 individuals who participated in physical exercise. An analysis was conducted and was found that the participants who were not engaging in physical exercise were more likely to develop depression and anxiety symptoms than those who participated in physical activities. The authors conclude that engagement in physical activities could play a crucial role in reducing levels of anxiety and the chances of developing depression. The main strength of this study is that the authors recruited participants from both genders, which is a representation of reality on the ground. The main weakness is that a very small sample has been used to represent the entire population, which could lead to biases as a result of the generalization of conclusions.
Mura and Carta (2013) carried out an investigation to determine the effectiveness of physical activity on depression among the geriatric population, focusing on the co-prescription of anti-depressant medications and physical exercise. The research was a systematic review study where the authors used medical databases such as Medline and PubMed to search for relevant peer-reviewed articles with relevant information. They used keywords and phrases such as depression, depressive disorder, depressive symptoms, exercises, physical fitness, physical activity, elderly, old people, and late-life. Following a thorough search, they settled on 44 articles with the most relevant information to their study. Their findings showed that although limited progress concerning the impact of physical activity on depression has been achieved due to clinical issues of depression management and limit research has been made for the past 20 years, there were positive findings that physical exercise combined with anti-depressants could reduce depression among elderly. One of the strengths of the study is that the authors selected peer-reviewed articles that all had relevant information concerning the effects of physical activities on depression. Weaknesses include ...