Prognostic value of depressive symptoms on mortality, morbidity and nursing home admission in older people.

AIM

Depression is frequently encountered in hospitalized elderly persons. Studies have found an independent association between depressive symptoms, mortality and functional decline. Only a few studies look specifically at other potential effects of depressive symptoms, such as subsequent hospital readmission or nursing home admission. In this study, we aim to investigate the association between the presence of depressive symptoms and nursing home placement, hospital admission and mortality in a group of geriatric outpatients receiving rehabilitation.

METHODS

All community dwelling elderly patients with no history of depression or cognitive impairment who were new attendances of a geriatric day hospital of a regional hospital in Hong Kong were recruited. Baseline demographic data, medical comorbidities, functional status and presence of depressive symptoms defined as a Geriatric Depression Scale score of more than 8 were recorded. Outcome variables were mortality, nursing home admission and unplanned hospital admission rate at 1 year.

RESULTS

Two hundred and nine subjects were included with a mean age of 77.4 years (standard deviation, 7.6). There was no statistically significant difference on mortality at 1 year and nursing home admission. However, depressed subjects were found to have increased risk of hospital admission (odds ratio = 2.67, 95% confidence interval = 1.31, 5.32) and have more episodes of unplanned hospital admission (odds ratio = 1.52, 95% confidence interval = 1.1, 2.12).

CONCLUSION

Elderly patients with depressive symptoms are associated with increased risk of hospital admission and greater inpatient service utilization, independent of their functional status. These results emphasize the need to improve the management of depressive symptoms and heighten the recognition and treatment of depression in the elderly population.