Functional status, symptoms of depression, and the outcomes of hospitalization in community-dwelling elderly patients.

OBJECTIVE

To assess the relationship between symptoms of depression at admission and postdischarge medical outcomes in hospitalized elderly patients.

DESIGN

Prospective cohort study.

METHODS

Patients screened for symptoms of depression at admission using the Geriatric Depression Scale underwent assessment 1 month after discharge to determine outcomes of hospitalization.

SETTING

A 370-bed, acute care, community hospital.

PATIENTS

A sample of 197 cognitively intact, community-dwelling elderly patients, aged 70 years and older, hospitalized with medical diagnoses, with expected lengths of stay of 48 hours or more.

MAIN OUTCOME MEASURE

The Medical Outcomes Study Short-Form instrument was used to obtain data on 1-month postdischarge medical outcomes with respect to physical functioning, health status, and mental status.

RESULTS

On admission, a total of 23.9% had symptoms of depression (Geriatric Depression Scale score, > or = 11) that were significantly related to preadmission functional status. In multivariate analyses, depressive symptoms at admission were significantly related to 1-month medical outcomes, independent of functional status.

CONCLUSIONS

Findings suggest that depressive symptoms in hospitalized elderly may be reactive to physical disability and characterize a group of patients who have poorer functional status prior to admission. The effect of depressive symptoms on 1-month postdischarge medical outcomes, however, appears to be independent of and in addition to the effects of preadmission functional status.