title: Observer-rated depression in long-term care: frequency and risk factors.
abstract: The objectives of this study were: (1) to describe the prevalence and 6-month incidence of observer-rated depression in residents age 65 and over of long-term care (LTC) facilities; (2) to describe risk factors for depression, at baseline and over time. A multisite, prospective observational study was conducted in residents aged 65 and over of 7 LTC facilities. The Cornell Scale for Depression in Dementia (CSDD) was completed by nurses monthly for 6 months. We measured demographic, medical, and functional factors at baseline and monthly intervals, using data from research assessments, nurse interviews, and chart reviews. 274 residents were recruited and completed baseline depression assessments. The prevalence of depression (CSDD score of 6+) was 19.0%. The incidence of depression among those without prevalent depression was 73.3 per 100 person-years. A delirium diagnosis, pain, and diabetes were independently associated with prevalent depression. CSDD score at baseline and development of severe cognitive impairment at follow-up were independent risk factors for incident depression. A diagnosis of delirium and uncorrected visual impairment at follow-up occurred concurrently with incident depression. The results of this study have implications for the detection and prevention of depression in LTC. Delirium diagnosis, pain and diabetes at baseline were associated with prevalent depression; depression symptoms at baseline and development of severe cognitive impairment at follow-up were risk factors for incident depression.
authors.affiliation: St. Mary's Research Centre, St. Mary's Hospital Center, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada. Electronic address: jane.mccusker@mcgill.ca.
authors.forename: Jane
authors.initials: J
authors.lastname: McCusker
authors.affiliation: Psychiatry, St. Mary's Hospital and McGill University, Montreal, Quebec, Canada.
authors.forename: Martin G
authors.initials: MG
authors.lastname: Cole
authors.affiliation: Faculty of Nursing Sciences, Laval University, Quebec, Quebec, Canada.
authors.forename: Philippe
authors.initials: P
authors.lastname: Voyer
authors.affiliation: Division of Geriatric Medicine, Sir Mortimer B Davis Jewish General Hospital, Montreal, Quebec, Canada; Donald Berman Maimonides Geriatric Center, Montreal, Quebec, Canada.
authors.forename: Johanne
authors.initials: J
authors.lastname: Monette
authors.affiliation: Département de médecine familiale, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Champoux
authors.affiliation: St. Mary's Research Centre, St. Mary's Hospital Center, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ciampi
authors.affiliation: Division of Geriatric Medicine, Centre Hospitalier de l'Université de Montréal and Department of Medicine, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Minh
authors.initials: M
authors.lastname: Vu
authors.affiliation: St. Mary's Research Centre, St. Mary's Hospital Center, Montreal, Quebec, Canada.
authors.forename: Alina
authors.initials: A
authors.lastname: Dyachenko
authors.affiliation: St. Mary's Research Centre, St. Mary's Hospital Center, Montreal, Quebec, Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: Belzile
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D003072:Cognition Disorders / Q000453:epidemiology; D015897:Comorbidity; D003693:Delirium / Q000453:epidemiology; D003704:Dementia / Q000453:epidemiology; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008134:Long-Term Care; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011792:Quebec / Q000453:epidemiology; D012307:Risk Factors; D012959:Socioeconomic Factors
keywords: Cognitive aging; Delirium; Depression; Nursing home