Improving mental health of older people through multidisciplinary efforts

The research project, executed by a multidisciplinary consortium of eight research groups, was aimed at enhancing the understanding of mental health in older people and improving services for this demographic. The study, which spanned four years starting from 2009, involved national and international partners and investigated three patient cohorts known to have a high prevalence of depression, dementia, and delirium. These cohorts included 800 patients with hip fractures, 1,000 patients attending a memory clinic, and 1,000 patients receiving in-home nursing care.

Through the use of cross-sectional and longitudinal designs, the cohorts were described, and randomised controlled trials were conducted to examine the impact of pharmacological and non-pharmacological interventions. A common set of core variables were used to describe symptoms of depression, dementia, delirium, frailty, and disabilities across all patients.

In a subset of the population, the research scrutinized physical activity and its influence on mental health. For another subset, serum and whole blood were collected for the analysis of proinflammatory cytokines, cytochrome P450 genotype, drug concentrations, and other biological markers. The study also monitored all patients for at least three years to observe the transition to nursing home placement and in-home nursing care.

The project was divided into two phases. The first phase was observational, where the three patient populations were examined and followed up. The second phase comprised three interventional trials: a randomised controlled trial (RCT) studying the effect of physical exercise on depressive symptoms in patients with mild cognitive impairment or mild dementia combined with depression, an RCT investigating the effect of a comprehensive orthogeriatric unit for hip fracture patients, and a double-blind RCT examining the effect of haloperidol in the prevention and treatment of delirium.