Depressive symptoms, physician visits and hospitalization among community-dwelling older adults.
BACKGROUND
The relationship between depressive symptoms and health service use among older people is not well understood. In this study we examined the two-way relationships between depressive symptoms and hospitalization and/or physician visits by older adults.


METHODS
In a one-year follow-up study of 973 community-dwelling older adults in the Singapore Longitudinal Aging Studies (SLAS), depressive symptoms (15-item Geriatric Depression Scale score > or =5) were assessed at baseline and one year later. Information on self-reported physician visits and hospitalization were collected bimonthly over one year.


RESULTS
When demographic characteristics, medical comorbidities, functional status and other covariates were controlled for, baseline depressive symptoms were associated with increased episodes of subsequent physician visits during the one-year follow-up (RR,1.34; 95% CI, 1.05-1.70), but not with subsequent hospitalization(s) during the same period. Conversely, participants with five or more physician visits (versus less than 5) over one year were more likely to be depressed at one year (OR, 10.2; 95% CI, 3.36-31.1); hospitalization during this period was also significantly associated with depressive symptoms at one year (OR = 6.43, 95% CI, 2.48-16.6).


CONCLUSIONS
Depressive symptoms and health service use have reciprocal relationships. Health service use for non-mental illnesses may be optimized by efforts at post-hospitalization interventions to recognize and treat depression in older persons.
Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Liang
L
Feng
Keng Bee
KB
Yap
Ee Heok
EH
Kua
Tze Pin
TP
Ng
D000368:Aged; D002908:Chronic Disease; D003072:Cognition Disorders / Q000175:diagnosis; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data; D010821:Physicians, Family / Q000706:statistics & numerical data*; D011379:Prognosis; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index; D012846:Singapore