Depressive symptoms are associated with hospitalization, but not with mortality in the elderly: a population-based study.
OBJECTIVE
Subjects with depression might request more healthcare services. The aim of this study was to evaluate the association of depressive symptoms with hospitalization and mortality rates in a general unselected older population.


METHODS
We assessed the association of the 30-items Geriatric Depression Scale (GDS) score with one-year hospitalization and mortality in all 344 subjects aged 75+ living in Tuscania (Italy). This population had been enrolled in a national study of the genetic determinants of health status. Analyses were conducted using continuous, as well as categorical GDS score levels.


RESULTS
After adjusting for potential confounders, depressive symptoms were associated in Cox regression modelling with hospitalization (relative risk, RR = 1.05; 95% confidence interval, CI = 1.01-1.09; p = 0.016), but not with mortality (RR = 1.06; 95% CI = 0.96-1.16; p = 0.246). Increasing GDS score levels were associated with increasing risk of hospitalization (p for trend = 0.033). Up to 39% of hospitalizations might be attributed to depression.


CONCLUSIONS
Depressive symptoms are not associated with increased mortality rates in general older populations. However, depressive symptoms represent a potentially reversible determinant of increased hospitalization rates in these subjects, independent of the presence and severity of other medical conditions.
Department of Gerontology and Geriatrics, Catholic University of Medicine, Largo Francesco Vito 1, 00168 Rome, Italy. postalice@tiscali.it
Alice
A
Laudisio
Emanuele
E
Marzetti
Francesco
F
Pagano
Gino
G
Pozzi
Roberto
R
Bernabei
Giuseppe
G
Zuccala
D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D003863:Depression / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D011159:Population Surveillance; D016016:Proportional Hazards Models; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors