Apr 04, 2023

Depression treatment trial programs create hope for older people

Two major trials for depression treatment and management could change the way older Australians improve their mental health.

Although there are no exact figures, between 10-15% of people aged over 65 experience depression, but those rates could be higher as many are reluctant to acknowledge their mental health challenges.

Those rates are believed to be even higher for older people living in residential aged care and those facing social isolation at home. But these new initiatives could prove beneficial for a large number of people.

Dr Wei Lee, HammondCare Palliative Care Staff Specialist, was awarded the Cancer Symptoms Trials (CST) Emerging Trialist Award as the co-ordinating principal investigator on a groundbreaking study that examined the benefits of ketamine infusions in palliative care settings.

While ketamine is commonly used as an anaesthetic, there are concerns over its usage as a recreational drug due to its dissociative and hallucinogenic outcomes. 

But in collaboration with the Improving Palliative, Aged and Chronic Care through Research and Translation (IMPACCT) research centre at the University of Technology, Sydney, the research focused on providing high-quality palliative care mental health support for people with cancer. 

But Dr Lee realised there is greater potential for the drug when administered safely and in safe doses.

“Major depression at end of life is so very sad for patients and those they love, they lose the care factor,” Dr Lee said.

“We know that if we give ketamine at a high rate it leads to hallucinations and weird sensory challenges and it does more harm than good.

“What we are learning now is that at super low doses it might help major depression symptoms without the side effects.”

While the final research has not been released – it’s expected to come out later this year – it may be another beneficial tool for palliative and end-of-life care for older people with cancer or any terminal illness. 

“His work has provided us with some important methodological learnings for clinical trials for people living with cancer with short prognosis,” CST Scientific Advisory Committee Chair, Dr Belinda Butcher, said.

Meanwhile, Swinburne University of Technology will partner with residential aged care provider Silverchain to deliver a digital intervention for depression for older people receiving support services at home. 

Backed by Aged Care Research and Industry Innovation Australia (ARIIA) funding, e-EMBED (Electronic-Enhanced Management of Home-Based Elders with Depression) provides self-directed psychological strategies for home care clients to access in their own time.

It means people who are more reluctant to speak up to others or seek help can autonomously access digital resources and tools without fear of discomfort or unnecessary pressure.

Silverchain Director of Research Discovery, Professor Tanya Davison, said there is no digitally-enabled mental health intervention designed and developed specifically for in-home care clients.

“This program will enable older Australians to access evidence-based treatments and communicate effectively with a mental health clinician in the comfort of their own homes,” Professor Davison said.

The trial between Swinbourne and Silverchain takes previous interest and feedback from home care clients and it will develop the right tools to successfully introduce digital mental health supports at home.

“The next step is to develop and pilot the digital psychological intervention for depression and evaluate its use in the home context,” Swinbourne Clinical Geropsychologist, Professor Sunil Bhar, said.

“The design of the final product needs to be carefully planned together with people with depressive symptoms based on their preferences, level of digital literacy, and comfort using technology to improve their health and wellbeing.”  

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