Development of Hybrid Model for Integrating Management of Geriatric Depression and Dementia in Urban Area

ABSTRACT

Background: Depressive symptoms and cognitive decline are the common neuropsychiatric symptoms among the old. Screening of the cognitive decline should be accompanied with the screening of depression because the geriatric depression is frequently comorbid with dementia. Methods: The members of the geriatric division working group of the Seoul Metropolitan mental health advisory committee had a monthly expert meeting from January to December 2005. We searched the cases of the local and international geriatric mental health services. After the presentation in the action plan review committee of the Seoul city, authors made revisions and modified the hybrid form of geriatric mental health management plan. Results: The purposes of this plan are (1) development of screening system of geriatric mental health problems, (2) development of local suicide alarm system of the old, (3) installation of depression management system and suicide prevention system, (4) development of screening system of cognitive decline for the early detection of dementia, (5) development and installation of mental health promotion system for the old, (6) development of effective, continuous, personalized management system for the dementia patients, (7) development of linking system of the hospital and the related institutions, (8) installation of the educational programs for the geriatric mental health workers and the care-givers. This model of integrative management system for the geriatric mental health will be developed, tested and then be spread to the local community according to the three stages. Conclusion: The hybrid model for the geriatric mental health may contribute to enhancement of the quality and cost-effectiveness of community geriatric mental health management system. Thus this model may (1) decrease the incidence of geriatric depression and dementia, and (2) decrease the hospital utility and admission rate of the depressed, suicidal old. Also, this newly conceptualized hybrid system would increase the quality of lives of the geriatric population.