Table 4.

Directions for future clinical practice and research in late‐life depression

1.	Pragmatic intervention programs (e.g., collaborative, stepped‐care models) should be further developed and implemented, using both pharmacotherapy and depression‐specific psychotherapies (e.g., problem‐solving therapy, cognitive behavioral therapy, and interpersonal psychotherapy), amenable for use also in low‐ and middle‐income countries.
2.	Further comparative effectiveness/safety/tolerability research should be conducted to develop staged algorithms of care for use in both primary and specialty mental health settings, that will match needs of patients with intensity of intervention.
3.	Measurement‐based care should be promoted to optimize efficacy, tolerability, safety, and treatment adherence.
4.	The implications of staging models of depression for assessment, prevention and treatment should be further investigated.
5.	Indirect, less‐stigmatized approaches to depression prevention in older adults, such as treatment of insomnia disorder, should be further investigated.
6.	The use of lay counsellors, community health workers, and peer‐support specialists should be expanded through task sharing/shifting, to address the dearth of mental health specialists in low‐, middle‐ and high‐income countries.
7.	The use of telepsychiatry, especially to better reach under‐served and rural older adults, should be further integrated.
8.	There should be a focus on health‐span, not only on lifespan, in clinical care and in cost‐benefit analyses.
9.	A focus of research should be whether preventing and treating depression effectively modifies the risk for the major scourges of old age: cardiovascular disease, dementia and cancer.
10.	Further research should be conducted into suicide prevention in older adults, especially addressing high‐risk periods such as transitions from more to less intensive care settings.
11.	Research on ketamine should be expanded to include older adults, in order to further address the clinical care of those with treatment‐resistant depression, suicidal ideation, and cognitive impairment.
12.	Research in psychedelic‐assisted psychotherapy (e.g., psilocybin) for treatment‐resistant depression in older adults should be expanded.
13.	Pharmacogenomically‐informed clinical decision‐making for the care to older adults with major depression should be further explored.