Depressed mood, cognitive impairment, and survival in older people admitted to care homes in England.
OBJECTIVE
To investigate psychiatric morbidity, cognitive impairment, dependency, and survival in residents newly admitted to care homes.


METHODS
A total of 308 older people were assessed using measures of cognitive impairment and depressive symptomatology, and interviewable residents completed a quality-of-life interview. Dependency levels were assessed by interviews with staff and medication data were collected from home records. Follow-up assessments were carried out at five and nine months. A telephone follow-up approximately 12 months later augmented the survival data.


RESULTS
Of residents whose outcomes were known, 73% survived throughout the nine-month study period. Residents who died before the five-month follow-up had higher scores on the depression measure than those surviving longer. Reduced survival was predicted by greater dependency at baseline. Of 188 surviving residents, 63 (38%) were classified as depressed at baseline. Twenty-seven (43%) of the latter were still classed as depressed at five and nine months. Just 19% of residents rated as depressed at baseline were prescribed antidepressant medication, increasing to 26% at each follow-up. There was significant coexistence of cognitive impairment and depressive symptomatology.


CONCLUSIONS
High levels of mortality, psychiatric morbidity, and chronicity of depressed mood among residents requires care homes to improve access to specialist resources such as geriatric consultation, old-age psychiatry, occupational therapy, and physiotherapy. Findings suggest that future care standards should include external factors, such as the extent of access to relevant specialist services for vulnerable older people.
Sutcliffe
Caroline
C
Personal Social Services Research Unit, University of Manchester, Manchester, United Kingdom. caroline.sutcliffe@manchester.ac.uk
Burns
Alistair
A
Challis
David
D
Mozley
Caroline Godlove
CG
Cordingley
Lis
L
Bagley
Heather
H
Huxley
Peter
P
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000401:mortality* / Q000523:psychology; D000928:Antidepressive Agents / Q000627:therapeutic use; D015331:Cohort Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000188:drug therapy / Q000401:mortality* / Q000523:psychology; D004739:England; D005260:Female; D005500:Follow-Up Studies; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data*; D011788:Quality of Life / Q000523:psychology; D016019:Survival Analysis
D000928:Antidepressive Agents