title: Six-month trajectories of self-reported depressive symptoms in long-term care.
abstract: BACKGROUND
  Depression is a common problem in long-term care (LTC) settings. We sought to characterize depression symptom trajectories over six months among older residents, and to identify resident characteristics at baseline that predict symptom trajectory.
  
  
  METHODS
  This study was a secondary analysis of data from a six-month prospective, observational, and multi-site study. Severity of depressive symptoms was assessed with the 15-item Geriatric Depression Scale (GDS) at baseline and with up to six monthly follow-up assessments. Participants were 130 residents with a Mini-Mental State Examination score of 15 or more at baseline and of at least two of the six monthly follow-up assessments. Individual resident GDS trajectories were grouped using hierarchical clustering. The baseline predictors of a more severe trajectory were identified using the Proportional Odds Model.
  
  
  RESULTS
  Three clusters of depression symptom trajectory were found that described "lower," "intermediate," and "higher" levels of depressive symptoms over time (mean GDS scores for three clusters at baseline were 2.2, 4.9, and 9.0 respectively). The GDS scores in all groups were generally stable over time. Baseline predictors of a more severe trajectory were as follows: Initial GDS score of 7 or more, female sex, LTC residence for less than 12 months, and corrected visual impairment.
  
  
  CONCLUSIONS
  The six-month course of depressive symptoms in LTC is generally stable. Most residents who experience a more severe symptom trajectory can be identified at baseline.
authors.affiliation: St. Mary's Research Centre,St. Mary's Hospital Center,Montreal,Quebec,Canada.
authors.forename: Jane
authors.initials: J
authors.lastname: McCusker
authors.affiliation: Department of 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 City,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.
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.
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: Eric
authors.initials: E
authors.lastname: Belzile
authors.affiliation: St. Mary's Research Centre,St. Mary's Hospital Center,Montreal,Quebec,Canada.
authors.forename: Chun
authors.initials: C
authors.lastname: Bai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000175:diagnosis*; D003866:Depressive Disorder / Q000175:diagnosis*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D016014:Linear Models; D008134:Long-Term Care; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D057566:Self Report
keywords: aged care; depression; long-term care; longitudinal studies