Objective
To determine the acceptability of clinical interventions for depression prevention,
identification of clinical characteristics associated with intervention engagement
is needed. The purpose of this study is to describe levels and correlates of participant
engagement in Problem Solving Therapy (PST) in adults 60 and older with subthreshold
depression.
Methods
As part of a clinical trial to prevent depression among older adults with subthreshold
depression, participants who were randomized to receive PST completed 6–8 sessions
in which they learned skills to solve self-selected problems that were contributing
to stress and reduced quality of life. To measure participants' engagement with PST,
interventionists completed 3 scales that rated participants' level of participation
in problem solving activities, understanding of the multistep process of PST, and
between-session homework effort. Using logistic regression, we examined whether physical
health, level of cognitive function, gait speed, and disability served as correlates
of engagement in the PST intervention.
Results
Gait speed, a measure of physical and cognitive health, was significantly associated
with engagement in PST. Participants who walked faster were more likely to engage
with PST compared to participants who walked more slowly. No other baseline variables
were significant correlates.
Conclusions
Older adults who walk more slowly may need alternative delivery methods to fully engage
in PST. Gait speed reflects physical and cognitive health, and predicts frailty, disability,
and psychomotor speed slowing. For these reasons, gait speed may be a marker for factors
that will serve to predict poorer engagement in psychosocial interventions like PST.
Key Words
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Article info
Publication history
Published online: March 13, 2017
Accepted:
March 6,
2017
Received in revised form:
March 3,
2017
Received:
November 28,
2016
Identification
Copyright
© 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
