title: Depressive symptoms after hospitalization in older adults: function and mortality outcomes.
abstract: OBJECTIVE
  To determine the relationship between depressive symptoms after hospitalization and survival and functional outcomes.
  
  
  METHODS
  Secondary analysis of a prospective cohort study.
  
  
  METHODS
  General medical service of two urban, teaching hospitals in Ohio.
  
  
  METHODS
  Hospitalized individuals aged 70 and older.
  
  
  METHODS
  Ten depressive symptoms, instrumental activities of daily living (IADLs), and basic activities of daily living (ADLs) were measured at hospital discharge and 1, 3, 6, and 12 months later. Participant-specific changes in depressive symptoms (slopes) were determined using all data points. Four groups were also defined according to number of depressive symptoms (≤3 symptoms, low; 4-10 symptoms, high) at discharge and follow-up: low-low, low-high, high-low, and high-high. Mortality was measured 3, 6, and 12 months after hospital discharge.
  
  
  RESULTS
  Participant-specific discharge depressive symptoms and change in depressive symptoms over time (slopes) were associated (P < .05) with functional and mortality outcomes. At 1 year, more participants in the low-low depressive symptom group (49%) were alive and independent in IADLs and ADLs than in the low-high group (37%, P = .02), and more participants in the high-low group (39%) were alive and independent in IADLs and ADLs than in the high-high group (19%, P < .001).
  
  
  CONCLUSIONS
  Number of depressive symptoms and change in number of depressive symptoms during the year after discharge were associated with functional and mortality outcomes in hospitalized older adults. Fewer participants with persistently high or increasing depressive symptoms after hospitalization were alive and functionally independent 1 year later than participants with decreasing or persistently low symptoms, respectively.
authors.affiliation: Division of Geriatrics, University of California at San Francisco, San Francisco, California 94110, USA. epierluissi@medsfgh.ucsf
authors.forename: Edgar
authors.initials: E
authors.lastname: Pierluissi
authors.forename: Kala M
authors.initials: KM
authors.lastname: Mehta
authors.forename: Katharine A
authors.initials: KA
authors.lastname: Kirby
authors.forename: W John
authors.initials: WJ
authors.lastname: Boscardin
authors.forename: Richard H
authors.initials: RH
authors.lastname: Fortinsky
authors.forename: Robert M
authors.initials: RM
authors.lastname: Palmer
authors.forename: C Seth
authors.initials: CS
authors.lastname: Landefeld
mesh_terms: D018806:APACHE; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003863:Depression / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D009026:Mortality; D010351:Patient Discharge; D020127:Recovery of Function