Although a focus on late-life depression may help preventing suicide in older adults, many older people, especially those living in rural areas, have relatively low accessibility to treatment. This study examined the feasibility and effectiveness of a village-based intervention for depression targeting older adults living in rural areas. A community-based randomised pilot trial was performed in two small rural villages in South Korea. Two villages were randomly selected and assigned to the intervention or active control group; all older adults living in the two villages (n = 451) were included in the intervention program or received standard Community Mental Health Service (CMHS) care, and the effectiveness of the program was examined using representative samples from both groups (n = 160). The 12-week intervention included case management according to individual risk level and group-based activities. Healthy residents living in the intervention village who played major roles in monitoring at-risk older individuals were supervised by CMHS staff. The score on the Korean version of the Geriatric Depression Scale-Short Form (SGDS-K) was the primary outcome, while social network, functional status, and global cognitive function were secondary outcomes. Linear mixed models including the factors of intervention group, time, and their interaction were used to examine group differences in changes in primary and secondary outcomes from baseline to follow up. Overall, there was no significant group × time interaction with respect to the SGDS-K score, but older individuals with more depressive symptoms at baseline (SGDS-K ≥ 6) tended to have a lower likelihood of progressing to severe depression at post-intervention. The social network was strengthened in the intervention group, and there was a significant group × time interaction (F[df1, df2], 5.29 [1, 153], p = 0.023). This study examined a 12-week village-based intervention for late-life depression in which the CMHS helped village-dwellers deal with late-life depression in their communities. Although the intervention improved social interactions among older adults, it did not reduce depressive symptoms. Further studies including more rural villages and long-term follow up are needed to confirm the effectiveness of this prevention program. NCT04013165 (date: 9 July 2019, retrospectively registered).

中文翻译：

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在社区居住的老年人中，以乡村为基础的干预措施对抑郁症的有效性：一项随机可行性研究

尽管关注晚年抑郁症可能有助于防止老年人自杀，但许多老年人，特别是生活在农村地区的老年人，获得治疗的机会相对较低。这项研究检验了针对农村地区老年人的以乡村为基础的干预措施对抑郁症的可行性和有效性。在韩国的两个小乡村中进行了一项基于社区的随机试验。随机选择两个村庄，并划入干预或主动对照组。居住在两个村庄中的所有老年人（n = 451）均被纳入干预计划或接受了标准的社区心理健康服务（CMHS）护理，并使用两组的代表性样本检查了该计划的有效性（n = 160） 。为期12周的干预包括根据个人风险水平和基于小组的活动进行病例管理。CMHS工作人员对生活在干预村中的健康居民起到了监测高危老年人的重要作用。主要结果是韩文版老年抑郁量表（SGDS-K）的得分，次要结果是社交网络，功能状态和整体认知功能。线性混合模型（包括干预组，时间及其相互作用的因素）用于检查从基线到随访的主要和次要结局变化的组差异。总体而言，关于SGDS-K得分，没有显着的组×时间交互作用，但是，在基线时抑郁症状较严重（SGDS-K≥6）的老年人在干预后发展为严重抑郁症的可能性较小。干预组的社交网络得到加强，并且存在显着的组×时间互动（F [df1，df2]，5.29 [1，153]，p = 0.023）。这项研究调查了一项为期12周的以乡村为基础的晚期抑郁症干预措施，其中CMHS帮助乡村居民应对社区中的晚期抑郁症。尽管该干预措施改善了老年人之间的社交互动，但并没有减轻抑郁症状。需要进一步的研究，包括更多的农村村庄和长期的后续行动，以确认该预防计划的有效性。NCT04013165（日期：2019年7月9日，追溯注册）。