What is the association between self-neglect, depressive symptoms and untreated medical conditions?
OBJECTIVE
There have been no studies describing the occurrence of untreated medical condition(s) in elders with depression who self-neglect. This study compares the prevalence of depression as indicated by an abnormal score ( > or = 5) on the Geriatric Depression Scale-Short Form (GDS-SF) between self-neglecters and matched non self-neglecting community-dwelling elders. It also describes the relationship between untreated medical condition(s) associated with self-neglect and abnormal scores on the GDS-SF.


METHODS
The two samples consisted of 50 self-neglect cases validated by Adult Protective Services and 50 matched non-self-neglecters recruited from a hospital geriatric unit. The cases and controls were matched on age, gender, ethnicity and socio-economic status when possible. All were assessed in their home. Each participant received a comprehensive geriatric assessment, which included the Geriatric Depression Scale-Short Form, the Mini-Mental State Exam, the Self-Rated Health and Mortality question, and the Physical Performance Test. A laboratory blood analysis was also conducted. Untreated medical condition(s) was determined during the assessment by a geriatric nurse practitioner.


RESULTS
There was a statistically significant difference in the distribution of abnormal GDS-SF scores between the self-neglect (n = 25, 51%) versus the control group (n = 14, 28%; X2 = 5.49, df = 1, p = .019). Self-neglecters with scores indicative of depression were also significantly more likely (56% vs. 21%) to have untreated medical condition(s) compared to self-neglecters scoring normal on the GDS-SF (OR = 4.84, 95% CI = 1.37-17.09).


CONCLUSIONS
Clinicians should anticipate untreated medical condition(s) in elderly patients with depressive symptomatology who self-neglect.
Burnett
Jason
J
CREST, University of Texas Medical School--Houston, Harris County Hospital District, USA. Jason_Burnett@hchd.tmc.edu
Coverdale
John H
JH
Pickens
Sabrina
S
Dyer
Carmel Bitondo
CB
D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003863:Depression / Q000150:complications* / Q000401:mortality / Q000523:psychology; D004552:Elder Abuse / Q000401:mortality* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012648:Self Care / Q000523:psychology*; D012959:Socioeconomic Factors; D015996:Survival Rate / Q000639:trends; D016312:Treatment Refusal / Q000523:psychology*; D014481:United States / Q000453:epidemiology