Treating depressed older adults in primary care: Narrowing the gap betweenefficacy and effectiveness

There is a gap between the efficacy of treatments for late-life depression under research conditions and the effectiveness of treatments as they occur in the "real world" of primary care. Considerable evidence supports the ef ficacy of treatments for late-life depression, but many depressed older adu lts either are not recognized or do not receive effective treatment for dep ression in primary care. Older adults face a range of special treatment bar riers: knowledge deficits; losses and social isolation; multiple medical pr oblems; and lack of financial resources. More research is needed to underst and these barriers and to study the effectiveness of multifaceted, populati on-based disease management interventions for late-life depression in prima ry care.