title: Association between depression and hospital outcomes among older men.
abstract: BACKGROUND
  Studies that have investigated the relation between depression and the type, nature, extent and outcome of general hospital admissions have been limited by their retrospective designs and focus on specific clinical populations. We explored this relation prospectively in a large, community-based sample of older men.
  
  
  METHODS
  A cohort of 5411 men aged 69 years and older enrolled in the Health in Men Study was assessed at baseline for depressive symptoms, defined as a score of 7 or higher on the 15-item Geriatric Depression Scale. Participants were followed for 2 years for occurrence and number of hospital admissions, type of hospital admission, length of hospital stay and inpatient death as recorded in the Western Australian Data Linkage System.
  
  
  RESULTS
  Of 339 men with depressive symptoms, 152 (44.8%) had at least 1 emergency hospital admission, compared with 1164 of 5072 (22.9%) nondepressed men (p < 0.001). In multivariate analyses, the presence of depressive symptoms was a significant independent predictor of hospital admission (hazard ratio 1.67, 95% confidence interval [CI] 1.38-2.01), number of hospital admissions (incidence rate ratio [IRR] 1.22, 95% CI 1.07-1.39) and total length of hospital stay (IRR 1.65, 95% CI 1.36-2.01).
  
  
  CONCLUSIONS
  Participants with depressive symptoms were at higher risk of hospital admission for nonpsychiatric conditions and were more likely to have longer hospital stays and worse hospital outcomes, compared with nondepressed participants. These results highlight the potential to target this high-risk group to reduce the burden of health care costs in an aging population.
authors.affiliation: Department of Public Health and Primary Care, Cambridge Institute of Public Health, Cambridge University, Cambridge, UK. amp68@medschl.cam.ac.uk
authors.forename: A Matthew
authors.initials: AM
authors.lastname: Prina
authors.forename: Martijn
authors.initials: M
authors.lastname: Huisman
authors.forename: Bu B
authors.initials: BB
authors.lastname: Yeap
authors.forename: Graeme J
authors.initials: GJ
authors.lastname: Hankey
authors.forename: Leon
authors.initials: L
authors.lastname: Flicker
authors.forename: Carol
authors.initials: C
authors.lastname: Brayne
authors.forename: Osvaldo P
authors.initials: OP
authors.lastname: Almeida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000453:epidemiology; D016009:Chi-Square Distribution; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D016012:Poisson Distribution; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015996:Survival Rate; D014904:Western Australia / Q000453:epidemiology