e., ≤$15,000) was negatively associated with antidepressant use, but the level of education, private/veterans insurance or MAP coverage, family support, and disability
score were not significant factors. Of need factors, the HAMD score and pain medication intake were not significantly associated with antidepressant use but antisee more anxiety medication intake was a significant factor. Table 3 Correlates of antidepressant intake: binary logistic regression results (N = 162) The OLS regression results (not shown in Table 3) found that the perceived effectiveness Inhibitors,research,lifescience,medical of antidepressants was negatively associated with being aged 70 or older (β = −0.321, t = −2.210, P = 0.031) and the HAMD score (β = −0.299, t = −2.320, P = 0.024). Sex and race/ethnicity were not significant correlates. However, caution is required in interpreting the results, given the small sample size. Discussion The study found that about half of the low-income, depressed, homebound older-adult participants were taking antidepressant medications. All predisposing factors (sex, age, Inhibitors,research,lifescience,medical and race/ethnicity) were Inhibitors,research,lifescience,medical significantly associated with the likelihood of antidepressant use, supporting H1a. Of the enabling factors, only income was a significant correlate. Of the need factors, severity of current depressive symptoms was not significantly
associated with antidepressant intake, partly because the study included only depressed participants. The cross-sectional data did not allow us to examine the severity of depressive symptoms prior to antidepressant use either. However, the finding that self-reported use of antianxiety
medication was positively associated with self-reported antidepressant use suggests the importance Inhibitors,research,lifescience,medical of comorbid anxiety and depression and associated symptom severity as a need factor. Thus, the logistic regression results did not support H1c and only partially supported H1b and H1d. The hypothesis regarding the factors associated with the participants’ perception of effectiveness of antidepressants was also partially supported Inhibitors,research,lifescience,medical as it was negatively associated with older age (70+) and higher HAMD scores, but it was not significantly associated with gender Dichloromethane dehalogenase and race/ethnicity. The negative relationship between age and antidepressant use appears to suggest an age cohort effect, with those aged 70 or older having a more negative predisposition toward antidepressant use than those aged 50–59. Based on the study’s finding that those aged 70 or older were also less likely to perceive their medications to be effective, some individuals in this age group may have stopped taking antidepressants. PCPs may also be reluctant to prescribe antidepressants to older patients, especially those with multiple medical conditions (Bruce et al. 2002; Ayalon et al. 2010). The finding may also reflect low-income, depressed, homebound older adults’ preference for nonpharmacological over pharmacological treatment.