Depression in older patients admitted for postacute nursing home rehabilitation.
OBJECTIVE
To describe the prevalence, recognition, and persistence of depression in older adults undergoing postacute rehabilitation in a nursing home (NH) setting and to explore the effect of depression on rehabilitation outcomes.


METHODS
Prospective cohort study.


METHODS
One rehabilitative NH in the Los Angeles area.


METHODS
One hundred fifty-eight patients (aged >/=65) admitted for postacute rehabilitation over a 9-month recruitment period.


METHODS
Depression was assessed using the 15-item Geriatric Depression Scale (GDS-15) or the Cornell Scale for Depression (in participants with dementia). Medical records were reviewed for documentation of depression and antidepressant use before and during the rehabilitative NH stay. Rehabilitation process was assessed using total amount of successfully completed therapy (minutes). Rehabilitation outcome was assessed using the motor component of the Functional Independence Measure (mFIM). Measures were performed at admission and 2 months later.


RESULTS
Of the 646 potentially eligible patients admitted during the study, 158 consented, and 151 were screened for depression. Forty-two (27.8%) had depressive symptoms (GDS=6 or Cornell=5). Of these, only 15 had a documented diagnosis of depression, and 12 were receiving antidepressants. Depression was associated with longer NH stay but not with discharge mFIM score. Two months later, depression persisted in 24 participants and was associated with worse mFIM (55.5+/-22.7 vs 67.0+/-23.7, depressed vs nondepressed; P=.03).


CONCLUSIONS
Depression was common, underrecognized, and undertreated in these postacute rehabilitation patients. Depression generally persisted and was associated with worse functional status at 2-month follow-up.
Webber
Adam P
AP
Geriatric Research, Education and Clinical Center, Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, California, USA. awebber@ucla.edu
Martin
Jennifer L
JL
Harker
Judith O
JO
Josephson
Karen R
KR
Rubenstein
Laurence Z
LZ
Alessi
Cathy A
CA
D000208:Acute Disease / Q000534:rehabilitation*; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D011446:Prospective Studies; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*