People over 65 who are depressed or anxious turn to complementary or alternative medicine more often than older people who are not anxious or depressed -  but not to treat their mental symptoms.

Joseph. G. Grzywacz, Ph.D., and colleagues from Wake Forest University School of Medicine reported in the Journal of Alternative and Complementary Medicine that 34.9 percent of people over 65 who had symptoms of anxiety or depression used complementary or alternative medicine (CAM), compared to 26.5 percent of those without mental symptoms.

When praying for health is considered a form of CAM and added in, the percentage jumps to 81.7 percent of those with mental symptoms, compared to 64.6 percent of those without.

But the results showed that fewer than 20 percent of those with anxiety or depression used CAM to treat it. That was a surprise.

“Based on previous research and models of health self management, it was anticipated that CAM use would be greater among older adults with self-reported anxiety or depression than those without such conditions,” said Grzywacz, associate professor of family and community medicine.

The results are based on the 2002 National Health Interview Survey (NHIS) Alternative Health Supplement, which Grzywacz said was “the largest and most representative study of CAM use in the U.S. population to date.” The survey included 30,785 persons who participated in face-to-face interviews with U.S. Census Bureau personnel.

People who answered “yes” to the question “During the past 12 months have you been frequently depressed or anxious?” were defined as having anxiety or depression, he said.

“The findings demonstrate that a significantly greater proportion of older adults with anxiety or depression, in contrast to those without these conditions, use CAM,” said Grzywacz. “These differences are driven by greater use of spiritual practices, relaxation techniques and non-vitamin, non-mineral natural products.”

But he added, “Older adults with anxiety or depression generally do not use CAM to treat their mental conditions.”

He said that the 2002 NHIS survey was the first with sufficient numbers of older adults to provide description of CAM use among those with anxiety and depression.

Grzywacz said that mental disorders among older adults are under-diagnosed and under-treated.

Partly, that’s because people over 65 don’t believe it is treatable. “Older adults frequently report that depressive feelings are a natural part of aging and may not view them as something requiring treatment,” said Grzywacz.

Another surprise was that there was no difference among race or ethnic groups in the use of CAM for poor mental health. Last December, Grzywacz and his team reported that, among people over 65, blacks and Native Americans make much greater use of home remedies than whites. The differences seemed to be based on culture rather than access to health care.

In the current study, he said, “in the absence of conventional treatment, we expected that minority elders would seek other therapies to manage their mental health.” But that didn’t happen.

Other investigators in the study included Thomas A. Arcury, Ph.D., from Family and Community Medicine, and Sara A. Quandt, Ph.D., Ronny A. Bell, Ph.D., Wei Lang, Ph.D., and Cynthia K Suerken, M.S., all from the Division of Public Health Sciences. The research was supported by the National Center for Complementary and Alternative Medicine.

Wake Forest University Baptist Medical Center