title: Depressive symptoms in elderly patients predict poor adjustment after somatic events.
abstract: OBJECTIVE
  The authors tested the hypothesis that elderly subjects with premorbid depressive symptoms are at increased risk of poor adjustment after a somatic event.
  
  
  METHODS
  The GLAS study contains a baseline assessment and a follow-up of subjects who experienced post-baseline acute myocardial infarction, cancer, congestive heart failure, or fall-related injury of the extremities within 5 years after baseline assessment. Follow-up was conducted at 8 weeks, 6 months, and 1 year after the somatic event. Of a baseline sample of 5,279 elderly subjects (57 and older), 1,124 subjects who experienced one of the specified events were contacted, and sufficient follow-up data were obtained from 558 subjects. Authors analyzed the course of self-reported physical, role, and social functioning, and general health and well-being in subjects without baseline limitations. Patients with poor adjustment after the event were compared with patients with good adjustment on baseline depressive symptoms. They used logistic-regression analysis, controlling for several confounders.
  
  
  RESULTS
  In multivariate analyses, pre-event depressive symptoms were associated with an increased risk of poor adjustment in terms of social and role functioning, well-being, and general health, but not physical functioning.
  
  
  CONCLUSIONS
  Elderly persons living in the community reporting depressive symptoms are at increased risk of poor psychosocial adjustment after a somatic event. Each reported baseline depressive symptom was associated with an increased risk of chronic decline; this finding stresses the importance of detecting and treating depression in community-living elderly persons.
authors.affiliation: Department of Psychiatry, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands. p.de.jonge@med.rug.nl
authors.forename: Peter
authors.initials: P
authors.lastname: de Jonge
authors.forename: Johan
authors.initials: J
authors.lastname: Ormel
authors.forename: Joris P J
authors.initials: JP
authors.lastname: Slaets
authors.forename: Gertrudis I J M
authors.initials: GI
authors.lastname: Kempen
authors.forename: Adelita V
authors.initials: AV
authors.lastname: Ranchor
authors.forename: Cornelia H M
authors.initials: CH
authors.lastname: van Jaarsveld
authors.forename: Winnie
authors.initials: W
authors.lastname: Scaf-Klomp
authors.forename: Robbert
authors.initials: R
authors.lastname: Sanderman
mesh_terms: D000275:Adjustment Disorders / Q000453:epidemiology* / Q000209:etiology*; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003863:Depression / Q000523:psychology*; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011446:Prospective Studies; D012307:Risk Factors; D013001:Somatoform Disorders / Q000523:psychology*