WhatsApp as a Remedy for Loneliness and Depression Among Older Adults

WhatsApp can be an extremely effective tool for alleviating loneliness and depression among older adults, as demonstrated by a study conducted in Guarulhos, the second-largest city in São Paulo state, Brazil (1^✔ ✔Trusted Source
Self-help mobile messaging intervention for depression among older adults in resource-limited settings: a randomized controlled trial

Go to source). The study is detailed in an article published in the journal Nature Medicine. Marcia Scazufca, a scientific researcher at Hospital das Clínicas (HC) and a professor at the University of São Paulo’s Medical School (FM-USP), is a co-corresponding author.

“This study was a randomized controlled trial with 603 participants over the age of 60, all registered with 24 primary care clinics within the SUS [Sistema Único de Saúde, Brazil’s national public health network]. These individuals were screened for depression and showed significant symptoms of the disorder. They were randomly assigned to two groups. The intervention group, consisting of 298 participants, received WhatsApp messages through the Viva Vida program twice daily, four days a week, for six weeks. These messages included educational content on depression and behavioral activation. The control group, made up of 305 participants, received a single educational message. Neither group received direct support from healthcare professionals,” Scazufca explained. The Viva Vida program translates to "Long Live Life".

Digital Messaging: A New Hope for Alleviating Elderly Depression

The average age of the participants was 65.1. Women were a large majority (74.8%). Although 603 people were initially recruited, only 527 (87.4%) completed the follow-up assessment. Symptoms of depression improved in 42.4% of the intervention group, compared with 32.2% in the control group. “This suggests that intervention in the form of mobile phone messages was an effective short-term treatment of depression for older people in areas with limited health services,” she said.

Selection of participants was based on answers to Patient Health Questionnaire-9 (PHQ-9), a widely validated screening tool used to assess the presence and severity of depression based on a scale from 0 to 27, with 0-4 indicating absence of depression, and 5-9, 10-14, 15-19, and 20-27 indicating mild, moderate, moderately severe and severe depression respectively.

“We invited everyone with a score of 10 or more in the initial assessment to participate, so that our sample included people with moderate as well as severe depression,” she said. Because many low-income elderly Brazilians are semi-literate or illiterate, the intervention group received three-minute audio messages or images but no text messages. The researchers took care to use simple language inspired by popular radio programs. Two actors, pseudonymously Ana and Léo, read the messages, which evolved from educational phrases about depression to guidance on behavioral activation and advice on avoiding a relapse.

“The difference of 10 percentage points between the intervention and control groups in terms of improvement may seem small, but considering the very low cost of Viva Vida and the very large proportion of the population it could potentially reach, these 10 pp could represent millions of people. Moreover, Viva Vida should be seen as a first step, which can be combined with other forms of intervention. It’s important to note that that vast majority of the participants had never received treatment of any kind for depression, and hadn’t even been diagnosed as depressed,” Scazufca said.

The result is especially relevant in a middle-income country like Brazil, where the number of older people is rising fast and mental health services are scant, she added. The low cost of the program and the ease with which it can be implemented means it can be replicated in other countries with similar or worse socioeconomic conditions and where conventional treatment is unavailable or unaffordable for many. “As we continue this type of research, we may find even stronger evidence of the benefits of digital mental health intervention and of extending the coverage of psychosocial treatment globally,” she said.

Reference:

1. Self-help mobile messaging intervention for depression among older adults in resource-limited settings: a randomized controlled trial - (https://www.nature.com/articles/s41591-024-02864-4.epdf)

Source-Medindia