Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong, China.
Geriatr Gerontol Int. 2011 Apr;11(2):174-9. doi: 10.1111/j.1447-0594.2010.00665.x. Epub 2010 Dec 10.
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.
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.
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).
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.
住院老年人中经常会出现抑郁症状。研究发现，抑郁症状与死亡率和功能下降之间存在独立关联。只有少数研究专门探讨了抑郁症状的其他潜在影响，例如随后的住院再入院或入住养老院。在这项研究中，我们旨在调查一组接受康复治疗的老年门诊患者中抑郁症状与入住养老院、住院和死亡之间的关系。
招募了香港一家地区医院老年日间医院的无抑郁或认知障碍病史的所有社区居住的老年新患者。记录了基线人口统计学数据、合并症、功能状态和存在的抑郁症状（定义为老年抑郁量表评分>8）。主要结局变量为 1 年内的死亡率、入住养老院率和非计划性住院率。
共纳入 209 例患者，平均年龄为 77.4 岁（标准差为 7.6）。1 年内死亡率和入住养老院率无统计学差异。然而，抑郁患者的住院风险增加（优势比=2.67，95%置信区间=1.31, 5.32），非计划性住院次数也更多（优势比=1.52，95%置信区间=1.1, 2.12）。
有抑郁症状的老年患者与住院风险增加和住院服务利用增加有关，独立于其功能状态。这些结果强调需要改善抑郁症状的管理，并提高对老年人群中抑郁的认识和治疗。
