The impact of depression and anxiety on well being, disability and use of health care services in nursing home patients.
OBJECTIVE
To determine the impact of depression and anxiety on well being, disability and use of health care services among nursing patients.


METHODS
The study-population consisted of 350 elderly nursing home patients from 14 nursing homes in the Netherlands. Well being, disability, use of health care services (i.e. assistance in ADL, paramedical care, number of medications) and depression and anxiety and other relevant characteristics (gender, age, education, marital status, urbanization, cognition, morbidity, social support) were measured cross-sectionally. Associations of well being, disability and use of health care services with independent baseline characteristics were assessed with bivariate and with multivariate analyses.


RESULTS
Presence of depression and/or anxiety was associated with significantly less well being, but not with more disability. Presence of depression and/or anxiety was also significantly associated with four of the seven indicators of health care service use measured in this study: less assistance in ADL, more consultation of medical specialists, a higher mean number of medications and more use of antidepressants.


CONCLUSIONS
Presence of depression and/or anxiety has a statistically and clinically significant negative impact on well being, but not on disability. Future studies should focus on interventions for improving the detection, diagnosis and treatment of depression and/or anxiety in the nursing home.
Department of Nursing Home Medicine, VU University Medical Center in Amsterdam. m.smalbrugge@vumc.nl
Martin
M
Smalbrugge
Anne Margriet
AM
Pot
Lineke
L
Jongenelis
Chad M
CM
Gundy
Aartjan T F
AT
Beekman
Jan A
JA
Eefsting
D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D015577:Geriatric Assessment; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009735:Nursing Homes / Q000706:statistics & numerical data*; D011788:Quality of Life / Q000523:psychology*