Does depression predict adverse outcomes for older medical inpatients? A prospective cohort study of individuals screened for a trial.
OBJECTIVE
to examine the relationship between depressive symptoms and hospital outcomes in an unselected consecutive sample of older medical inpatients.


METHODS
a prospective cohort study of individuals screened for a trial.


METHODS
medical wards of UK district general hospital in rural East Anglia.


METHODS
six hundred and seventeen medical inpatients aged 65+ were randomly selected from consecutive admissions. Baseline measures: 15-item Geriatric Depression Scale (GDS-15), the Abbreviated Mental Test Score (AMTS) and the Cumulative Illness Rating Scale-Geriatric (CIRS-G).


METHODS
length of hospital stay; discharge to a community hospital (for rehabilitation), institutional care or usual place of residence; dying in hospital.


RESULTS
depressive symptoms are independently associated with an increased likelihood of inpatient death and transfer to a community hospital for rehabilitation, but are not associated with longer length of stay.


CONCLUSIONS
research evaluating effectiveness of identification and treatment of depression in older medical inpatients should consider including inpatient death and use of rehabilitation services as potential outcomes.
Cullum
Sarah
S
West Suffolk Hospital and Department of Public Health and Primary Care, University of Cambridge, UK. sarah.cullum@awp.nhs.uk
Metcalfe
Chris
C
Todd
Chris
C
Brayne
Carol
C
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003863:Depression / Q000175:diagnosis*; D005260:Female; D015577:Geriatric Assessment; D017052:Hospital Mortality; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008403:Mass Screening / Q000379:methods*; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012047:Rehabilitation Centers / Q000706:statistics & numerical data; D012866:Skilled Nursing Facilities / Q000706:statistics & numerical data; D006113:United Kingdom