Depression in geriatric ED patients: prevalence and recognition.
OBJECTIVE
To determine the prevalence of depression in geriatric ED patients and to assess recognition of geriatric depression by emergency physicians.


METHODS
We conducted an observational survey of geriatric patients who presented to an urban, university-affiliated public hospital ED. A convenience sample of 259 patients aged 65 years or older were administered a brief, self-rated depression scale. Main outcome measures were prevalence of depression (using a predetermined cutoff score for detecting depression) and recognition of depression by the treating emergency physician, assessed by chart review.


RESULTS
Seventy subjects (27%; 95% confidence interval [CI], 22% to 32%) were rated as depressed. Depressed and nondepressed patients were not significantly different with regard to age, sex, race, or education. Forty-seven percent of nursing home residents were depressed, compared with 24% of those living independently (95% CI for difference of 23%, 6% to 41%). Patients who described their health as poor were also more likely to be depressed (33 of 65, 51%) than patients who reported their health to be good or fair (37 of 194, 19%) (95% CI for difference of 32%, 18% to 45%). Emergency physicians failed to recognize depression in all the patients found to be depressed on this scale (95% CI, 0 to 5%).


CONCLUSIONS
The prevalence of unrecognized depression in the geriatric ED patients we studied was high, especially in those who reported their health as poor. Use of a brief depression scale can aid recognition of depression in older patients, leading to appropriate referral and treatment.
Meldon
S W
SW
Department of Emergency Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH 44109, USA.
Emerman
C L
CL
Schubert
D S
DS
Moffa
D A
DA
Etheart
R G
RG
D000368:Aged; D003863:Depression / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D005260:Female; D005853:Geriatrics; D006304:Health Status; D006801:Humans; D008297:Male; D015995:Prevalence; D011581:Psychological Tests; D012680:Sensitivity and Specificity