Older patients' depressive symptoms 6 months after prolonged hospitalization: course and interrelationships with major associated factors.
The aim of this study was to examine the course of depressive symptoms in older patients 6 months following a prolonged, acute hospitalization, especially the interrelationships among depressive symptoms and its major associated factors. For this study, we conducted a secondary analysis of data from a prospective cohort study of 351 patients aged 65 years and older. Participants were recruited from five surgical and medical wards at a tertiary medical center in northern Taiwan and assessed at three time points: within 48 h of admission, before discharge, and 6 months post-discharge. The course of depressive symptoms was dynamic with symptoms increased spontaneously and substantially during hospitalization and subsided at 6 months after discharge, but still remained higher than at admission. Overall, 26.7% of older patients at hospital discharge met established criteria for minor depression (15-item Geriatric Depressive Scale (GDS-15) scores 5-9) and 21.2% for major depression (GDS-15 scores >10). As the strongest associated factors, functional dependence and nutritional status influenced depressive symptoms following hospitalization. Depressive symptoms at discharge showed significant cross-lagged effects on functional dependence and nutritional status at 6 months after discharge, suggesting a reciprocal, triadic relationship. Thus, treating one condition might improve the other. Targeting the triad of depressive symptoms, functional dependence, and nutritional status, therefore, is essential for treating depressive symptoms and improving the overall health of older adults hospitalized for acute illness.
Department of Health Care Management, University of Kang Ning, No. 188, Section 5, An-Chung Road, Tainan, Taiwan, ROC.
Chun-Min
CM
Chen
Institute of Statistics, National Chiao Tung University, 1001 Ta Hsueh Road, Hsinchu 300, Taiwan, ROC.
Guan-Hua
GH
Huang
Department of Nursing, National Taiwan University and National Taiwan University Hospital, 1, Jen-Ai Road, Section 1, Taipei 100, Taiwan, ROC. Electronic address: cherylchen@ntu.edu.tw.
Cheryl Chia-Hui
CC
Chen
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010351:Patient Discharge; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D013624:Taiwan / Q000453:epidemiology
Depressive symptoms; Functional status; Geriatric syndrome; Nutritional status; Older adults