title: Depressive symptoms and adverse outcomes from hospitalization in older adults: secondary outcomes of a trial of falls prevention education.
abstract: Depression is common in older people and symptoms of depression are known to substantially increase during hospitalization. There is little known about predictors of depressive symptoms in older adults or impact of common interventions during hospitalization. This study aimed to describe the magnitude of depressive symptoms, shift of depressive symptoms and the impact of the symptoms of depression among older hospital patients during hospital admission and identify whether exposure to falls prevention education affected symptoms of depression. Participants (n=1206) were older adults admitted within two Australian hospitals, the majority of participants completed the Geriatric Depression Scale - Short Form (GDS) at admission (n=1168). Participants' mean age was 74.7 (±SD 11) years and 47% (n=551) were male. At admission 53% (619 out of 1168) of participants had symptoms of clinical depression and symptoms remained at the same level at discharge for 55% (543 out of 987). Those exposed to the low intensity education program had higher GDS scores at discharge than those in the control group (low intensity vs control n=652, adjusted regression coefficient (95% CI)=0.24 (0.02, 0.45), p=0.03). The only factor other than admission level of depression that affected depressive symptoms change was if the participant was worried about falling. Older patients frequently present with symptoms of clinical depression on admission to hospital. Future research should consider these factors, whether these are modifiable and whether treatment may influence outcomes.
authors.affiliation: Monash University/Monash Health, Allied Health Research Unit, Monash Health Kingston Hospital, Cnr Warrigal and Kingston Rds, Cheltenham, VIC 3192, Australia. Electronic address: terrence.haines@monash.edu.
authors.forename: Terry P
authors.initials: TP
authors.lastname: Haines
authors.affiliation: Allied Health Research Unit, Monash Health Kingston Hospital, Cnr Warrigal and Kingston Rds, Cheltenham, VIC 3192, Australia.
authors.forename: Cylie M
authors.initials: CM
authors.lastname: Williams
authors.affiliation: The University of Notre Dame Australia, 19 Mouat Street (PO Box 1225), Fremantle, WA 6959, Australia.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Hill
authors.affiliation: Queensland University of Technology/Queensland Health, Australia.
authors.forename: Steven M
authors.initials: SM
authors.lastname: McPhail
authors.forename: Keith D
authors.initials: KD
authors.lastname: Hill
authors.affiliation: Curtin University, School of Physiotherapy, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Hill
authors.affiliation: University of Queensland, School of Health & Rehab Sciences, Brisbane, QLD 4072, Australia.
authors.forename: Sandy G
authors.initials: SG
authors.lastname: Brauer
authors.affiliation: Centre for Research in Evidence-Based Practice, Bond University, Faculty of Health Sciences and Medicine, QLD 4229, Australia.
authors.forename: Tammy C
authors.initials: TC
authors.lastname: Hoffmann
authors.affiliation: University of Western Australia, School of Medicine and Pharmacology Royal Perth Hospital Unit, 35 Stirling Highway, Crawley, WA 6009, Australia.
authors.forename: Chris
authors.initials: C
authors.lastname: Etherton-Beer
mesh_terms: D000056:Accident Prevention; D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000368:Aged; D001315:Australia; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment; D006760:Hospitalization; D006801:Humans; D007297:Inpatients / Q000193:education*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010351:Patient Discharge / Q000706:statistics & numerical data; D010353:Patient Education as Topic
keywords: Depression; Elderly; Falls; Hospital