Institute of Epidemiology & Health Care


Mental Health and psychological well-being in later life

This work includes the diagnosis and management of common mental disorders and loneliness in older people.  



Exploring the experiences and management of loneliness in later life, views of support from services including primary care as well as personal coping strategies.

Depression and anxiety

Mood in Later Life (Management of frailty, anxiety and depression: A qualitative study)

Rachael Frost, Pushpa Nair, Kalpa Kharicha, Rebecca Gould, Marta Buszewicz, Kate Walters

Feeling low or anxious is common in later life, particularly when people are becoming frailer and have difficulties with everyday activities such as cleaning, shopping or leaving the house, but currently few treatments are tailored to the issues experienced by this population. We are carrying out interviews with 25-30 frail older adults who feel low or anxious across urban and semi-rural areas. Interviews will explore experiences of feeling low or anxious, experiences of treatments they have received and how services could be better adapted to meet their needs. This project is funded by the NIHR School for Primary Care Research.

Non-pharmacological interventions for depression/anxiety in older adults with physical comorbidities affecting functioning: systematic review and meta-analysis

Rachael Frost, Yehudit Bauernfreund, Kate Walters

Depression and anxiety are common in later life, especially when people are also experiencing physical difficulties or multiple health conditions that make it difficult for them to stay independent. Therapies for depression and anxiety aimed at older people often target them as a single population, despite the different issues experienced by the ''oldest old" and those who are frailer compared to those who are younger and more active. We are reviewing randomised controlled trials assessing the effectiveness of non-pharmacological therapies (e.g. psychological therapies, exercise) for older people with health conditions affecting their independence and symptoms of anxiety or depression. The results from our review will provide evidence to develop new and more effective services to address depression and anxiety in this group of older people.

Funded by NIHR School for Primary Care Research. Prospero ID CRD42017068441

Engaging people who are becoming frailer in mental health research: public engagement project

Rachael Frost, Pushpa Nair, Kate Walters

Despite being the focus of a wide range of research, older people who are becoming frail are often 'researched on' rather than 'researched with'. This project aimed to ensure the voices of frail older people are heard within research regarding mood in later life. Funded by UCL Culture, we carried out a series of discussion groups and a photography project with Broxbourne Day Centre (Cheshunt) and Alsen Day Centre (Finsbury Park) to engage with service users about mental and emotional wellbeing in later life and research areas we should focus on in future. The findings from this engagement project were used to inform a systematic review and qualitative study on improving depression and anxiety in frailty.

A case study from this project can be found here

Some lessons learned from our project can be found here

How do healthcare professionals manage depression and refer older people to psychological therapies? A systematic review of qualitative studies.

Rachael Frost, Angela Beattie, Cini Bhanu, Kate Walters, Yoav Ben-Shlomo

Healthcare professionals are less likely to refer older people with depression to psychological therapies and are more likely to prescribe medication, particularly if they are in the 'older old' age groups (e.g. 80+ years). Our review aims to explore the reasons behind this, by bringing together previous studies looking at healthcare professionals' views regarding late-life depression and how it should be managed. This will help us to identify ways we can reduce this inequality in future. This project is being carried out in collaboration with University of Bristol and is funded by NIHR School for Public Health Research.

PROSPERO ID CRD42017055207. 

For further information about any of these studies please contact Dr Rachael Frost 

Public Mental Health programme (across the life-course)

The public mental health programme is being delivered by the NIHR School of Public Health Research (SPHR), a partnership of eight leading academic centres, including UCL. It focuses on promotion, prevention and population-wide approaches to influence positive and negative mental health outcomes. We aim to generate new knowledge which practitioners can use to deliver impact. Click here for further details