P141: BRIGHT (Building Resilience in Geriatric Health Today)

Abstract

Aims:

Geriatric depression and anxiety are increasingly relevant conditions in the ageing population of Singapore. Subsyndromal depression and anxiety in older adults is estimated at 20-50% of the population and often go undetected despite adverse effects on quality of life (Preisig et al., 2001), suicidality (Sadek and Bona, 2000), disability and inappropriate usage of medical services (de Beurs et al., 1999; Wagner et al., 2000), and cognition (Yoachim et al., 2013). BRIGHT is an early intervention group coaching programme to empower older adults to self-manage physical and mental health ailments so as to decrease healthcare utilization and expenditure. This paper aims to present the findings from three pilot runs of BRIGHT with older adults in the community setting.

Methodology:

BRIGHT consists of 4 half-day workshops with both didactic and interactive components that leverage on the group-based therapy setting to promote psychoeducation, self-reflection, and reminiscence. This was delivered by a multidisciplinary team comprising psychiatrists, psychologists, and medical social workers. Simple digital literacy skills were taught and a mobile application to promote active lifestyles was utilized.

Groups are kept small at less than 15 participants each who were referred from community partners. They have been screened for subclinical depression and anxiety using the Geriatric Depression Scale (GDS), Geriatric Anxiety Inventory (GAI), 12-item Short Form Survey (SF-12), and Health Confidence Score (HCS). The same scales were administered again immediately upon completion of the programme to capture (1) reduction in depressive and anxiety symptoms, (2) quality of life, (3) improvement in health confidence, and (4) participant satisfaction.

Result:

Average participant satisfaction was 82.2% - most qualitative feedback was positive but one group preferred the sessions to be conducted in Mandarin instead of English. GDS, GAI, HCS, and SF12 PCS scores improved by an average of 2.285, 0.969, 0.685, and 1.733 respectively. However, SF12 MCS scores decreased by an average of 1.795.

Conclusion:

Preliminary quantitative data shows that BRIGHT appears to be an effective early intervention modality for older adults with subclinical depressive and anxiety symptoms. After an iterative process of refining the programme content, plans are underway to “train the trainers” so as to increase scale and sustainability.