Given the prevalence and morbidity of depression and anxiety in later life, the inadequacies
of current treatment approaches for averting years living with disability, the disparities
in access to the mental healthcare delivery system, and the workforce shortages to
meet the mental health needs of older Latinos, development and testing of innovative
strategies to prevent depression and anxiety are of great public health significance
and have the potential to change practice. Although impediments to good depression
and anxiety outcomes exist for all older adults, they are even more pronounced for
older Latinos, who tend to have fewer socioeconomic resources. These factors underscore
the need for prevention-based interventions that are effective, scalable, relevant,
respectful, and specific to this population. The Happy Older Latinos are Active (HOLA)
program is a community health worker–led, multicomponent, health promotion intervention.
The diverse needs and circumstances of older Latinos (highly sedentary, culture-specific
health beliefs, service disparities) were incorporated into the design of HOLA to
reduce risk factors and improve health-related outcomes associated with common mental
disorders in this group. The authors describe HOLA (highlighted in this case example)
and why health promotion interventions like HOLA may hold promise as effective, practical,
and nonstigmatizing interventions for preventing common mental disorders in older
Latinos who are at risk for developing these disorders.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of Geriatric PsychiatryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Administration on Aging: A profile of older Americans.(Available at:)https://www.acl.gov/sites/default/files/Aging%20and%20Disability%20in%20America/2012profile.pdf(Accessed November 18, 2016)Date: 2012
- Prevalence of psychiatric illness among ethnic minority older adults.J Am Geriatr Soc. 2010; 58: 256-264
- Disparities in mental health service use among ethnic minority adults.J Am Geriatr Soc. 2013; 61: 18-25
- Social inequalities in response to antidepressant treatment in older adults.Arch Gen Psychiatry. 2006; 63: 50-56
- The prevalence and health burden of self-reported diabetes in older Mexican Americans: findings from the Hispanic Established Populations for Epidemiologic Studies of the Elderly.Am J Public Health. 1999; 89: 546-551
- Obesity and health conditions in elderly Mexican Americans: the Hispanic EPESE. Established Population for Epidemiologic Studies of the Elderly.Ethn Dis. 2000; 10: 31-38
- Stigmatizing attitudes toward mental illness among racial/ethnic older adults in primary care.Int J Geriatr Psychiatry. 2012; 28: 1061-1068
- Cultural beliefs and treatment preferences of ethnically diverse older adult consumers in primary care.Am J Geriatr Psychiatry. 2012; 20: 533-542
- Crossing the Quality Chasm: A New Health System for the 21st Century.New Academy Press, Washington, DC2001
- Treatment in psychiatry: early intervention to preempt major depressive episodes in at-risk older Blacks and Whites.Psychiatr Serv. 2014; 65: 765-773
- Coaching in healthy dietary practices in at-risk older adults: a case of indicated depression prevention.Am J Psychiatry. 2014; 171: 499-505
- Improving health-related quality of life in older African American and non-Latino White patients.Am J Geriatr Psychiatry. 2015; 23: 548-558
- Physical activity in the prevention and treatment of anxiety and depression.Nord J Psychiatry. 2008; 62: 25-29
- The Happy Older Latinos are Active (HOLA) health promotion and prevention study: study protocol for a pilot randomized controlled trial.Trials. 2015; 16: 579-587
- The PHQ-9: validity of a brief depression severity measure.J Gen Intern Med. 2001; 16: 606-613
- A brief measure for assessing generalized anxiety disorder: the GAD-7.Arch Intern Med. 2006; 166: 1092-1097
- The Mini International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview.J Clin Psychiatry. 1998; 59: 22-33
- Age and education correction of Mini-Mental State Examination for English and Spanish-speaking elderly.Neurology. 1996; 46: 700-706
- Comfortable and maximum walking speed of adults aged 20–79 years: reference values and determinants.Age Ageing. 1997; 26: 15-19
- An inventory for measuring clinical anxiety: psychometric properties.J Consult Clin Psychol. 1988; 56: 893-897
- Antidepressant drug effects and depression severity: a patient-level meta-analysis.JAMA. 2010; 303: 47-53
- Physical activity, exercise, depression and anxiety disorders.J Neural Transm. 2009; 116: 777-784
- How effective are physical activity interventions for alleviating depressive symptoms in older people? A systematic review.Clin Rehabil. 2008; 23: 873-887
- Exercise training and depression in older adults.Neurobiol Aging. 2005; 26: 119-123
- Exercise and pharmacotherapy in the treatment of major depressive disorder.Psychosom Med. 2007; 69: 587-596
- Behavioral activation treatment for depression: returning to contextual roots.Clin Psychol Sci Pract. 2001; 8: 255-270
- Synergistic effect of social support and self-efficacy on physical exercise in older adults.J Aging Phys Act. 2011; 19: 249-261
- Social ties and psychological well-being in late life: the mediating role of relationship satisfaction.Aging Ment Health. 2015; 19: 1103-1112
- Is the naturalistic course of depression in older people related to received support over time? Results from a longitudinal population-based study.Int J Geriatr Psychiatry. 2017; 32: 657-663
- Biological and social predictors of long-term geriatric depression outcome.Int Psychogeriatr. 2005; 17: 41-56
- The relationship between depressive symptoms and walking among Hispanic older adults: a longitudinal, cross-lagged panel analysis.Aging Ment Health. 2010; 14: 211-219
- Physical activity dose–response effects on outcomes of depression and anxiety.Med Sci Sports Exerc. 2001; 33: S587-S597
- Lifelong physical activity patterns of sedentary Mexican American women.Geriatr Nurs. 2006; 27: 209-213
- The longitudinal relationship between depression and walking behavior in older Latinos: the “¡Caminemos!” study.J Aging Health. 2013; 25: 319-341
- Health behavior change benefits: perspectives of Latinos with serious mental illness.Transcult Psychiatry. 2016; 53: 313-329
- National trends in ethnic disparities in mental health care.Med Care. 2007; 45: 1012-1019
- Ethno-cultural variations in the experience and meaning of mental illness and treatment: implications for access and utilization.Transcult Psychiatry. 2010; 47: 224-251
- Depression in US Hispanics: diagnostic and management considerations in family practice.J Am Board Fam Pract. 2005; 18: 282-296
- The underside of the silver tsunami—older adults and mental health care.N Engl J Med. 2013; 368: 493-496
- Promotoras as mental health practitioners in primary care: a multi-method study of an intervention to address contextual sources of depression.J Commun Health. 2011; 36: 316-331
- Subthreshold depressive and anxiety disorders in the elderly.Eur Psychiatry. 2000; 15: 173-182
- The prevalence, clinical relevance, and public health significance of subthreshold depressions.Psychiatr Clin North Am. 2002; 25: 685-698
- The burden of late-life generalized anxiety disorder: effects on disability, health-related quality of life, and healthcare utilization.Am J Geriatr Psychiatry. 2009; 17: 473-482
- Reducing suicidal ideation and depressive symptoms in depressed older primary care patients: a randomized controlled trial.JAMA. 2004; 291: 1081-1090
Article info
Publication history
Published online: June 29, 2017
Accepted:
June 23,
2017
Received in revised form:
June 22,
2017
Received:
April 13,
2017
Identification
Copyright
© 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
