Elderly patients with arthritis and depression who receive therapy for depression have improved mood, less pain and disability due to arthritis, and an improved quality of life, according to an article in the November 12th issue of the Journal of the American Medical Association.

According to background information in the article, both depression and arthritis are disabling and common in older people. Depression, with a prevalence of about 16 percent among the elderly, is also a risk factor for functional disability and poor health outcomes among arthritis patients. Osteoarthritis is the most common type of arthritis among older adults; almost 80 percent of people more than 70 years of age have degenerative joint disease.

The current study was a randomized controlled trial (Improving Mood-Promoting Access to Collaborative Treatment [IMPACT]) that was conducted to assess the effects of improving treatment for depression among older adults in primary care settings. The study included 1,801 depressed older adults (age 60 years or older) and was performed at 18 primary care clinics across the United States from July 1999 to August 2001. A total of 1,001 people (56 percent) reported coexisting arthritis at baseline.

Participants were randomized to usual care or an intervention designed to enhance care for depression with use of antidepressant medications, 6 to 8 sessions of a psychotherapy program, or both.

After 12 months, people in the intervention group not only had reduction in depressive symptoms, they had lower average scores for pain intensity and interference with daily activities due to arthritis in comparison with patients in the usual care group. Overall health and quality of life were also enhanced among intervention patients compared with usual care patients.

"From a clinical perspective, current medical treatments cannot cure osteoarthritis nor eliminate arthritis-related pain and disability entirely. Therefore, arthritis management needs to be aimed at decreasing pain, improving function, and enhancing quality of life," the authors wrote.

"Across diverse general health care settings, we found high comorbidity of arthritis and late-life depression. Benefits from increased recognition and improved treatment of depression in patients with comorbid arthritis and depression extended beyond reduced depressive symptoms to include improved pain and functional outcomes. We conclude that recognition and treatment of depression has the potential to lessen the public health burden of comorbid arthritis and late-life depression."