Peer Companionship for Mental Health of Older Adults in Primary Care: A Pragmatic, Nonblinded, Parallel-Group, Randomized Controlled Trial

HIGHLIGHTS • What is the primary question addressed by this study? Does peer companionship delivered by an aging services agency to socially disconnected older adult primary care patients result in improvement in suicidal ideation, depression, anxiety, and psychological connectedness? • What is the main finding of the study? Older adults who received the peer companionship intervention had greater improvement in symptoms of depression, anxiety, and feelings of being a burden on others than those who did not have a peer companion. Levels of suicidal ideation and feelings of belonging improved in both groups. • What is the meaning of the finding? By improving social connectedness, peer companionship as delivered by community-based social services can contribute to the mental health and well-being of older adults.
Objectives To determine whether peer companionship delivered by an aging services agency to socially-disconnected older adult primary care patients was associated with improvement in suicidal ideation depression, anxiety, and psychological connectedness. Design Pragmatic, non-blinded, parallel-group, randomized controlled trial comparing peer companionship, The Senior Connection (TSC), to care-as-usual (CAU). Setting Lifespan, a non-medical, community-based aging services agency. Participants Adult primary care patients ages ≥60 years who endorsed feelings of loneliness or being a burden on others. Intervention TSC was delivered by Lifespan volunteers who provided supportive visits and phone calls in the subjects’ homes. CAU involved no peer companion assignment. Measurements The primary outcome was suicidal ideation assessed by the Geriatric Suicide Ideation Scale; secondary outcomes were depression, anxiety, and feelings of belonging and being a burden on others. Data were collected at baseline, 3-, 6-, and 12-months. Results Subjects (55% female) had a mean age of 71 years. There was no difference between groups in change in suicidal ideation or belonging. Subjects randomized to TSC had greater reduction in depression (PHQ-9; 2.33 point reduction for TSC vs. 1.32 for CAU, p=0.05), anxiety (GAD-7; TSC 1.52 vs. CAU 0.28, p=0.03), and perceived burden on others (INQ; 0.46 TSC vs. 0.09 CAU, p