title: Depression Predicts Functional Outcome in Geriatric Inpatient Rehabilitation.
abstract: To evaluate the effect of depression on functional recovery in geriatric patients who have completed an inpatient rehabilitation program.
  
  
  
  Prospective cohort study.
  
  
  
  Inpatient rehabilitation unit of a university-affiliated geriatric hospital.
  
  
  
  Convenience sample of patients (N=65; mean age, 81.6y; 25 men) admitted to rehabilitation over a 10-month period. Patients >60 years of age who were proficient in English and capable of providing informed consent were eligible to participate in the study.
  
  
  
  Depression was assessed using both the Geriatric Depression Scale-short form (GDS-15) and the Patient Health Questionnaire (9-item screen for depression) (PHQ-9). Measures of well-established predictors of rehabilitation outcome, which may interact with depression, were also obtained, and multiple regression linear modeling was used to evaluate the relation between depression and functional outcome over and above the contribution of these other factors.
  
  
  
  FIM (Functional Independence Measure) at discharge from the rehabilitation program.
  
  
  
  Depression, as assessed by the GDS-15, but not the PHQ-9, was predictive of functional outcome (standardized beta=-.151, P=.030) after controlling for other significant predictors, which included baseline disability, pain, cognition, and educational level. Participation in recreational, but not physio- or occupational, therapy additionally contributed to a small amount of variance in the functional outcome.
  
  
  
  Our findings suggest that self-report of depression is an independent predictor of functional outcome in high-tolerance, short-duration geriatric rehabilitation. Routine assessment of depressive symptoms in older adults using an instrument (eg, GDS-15) may help identify those at risk for poorer outcomes in rehabilitation.
authors.affiliation: Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
authors.forename: Saba
authors.initials: S
authors.lastname: Shahab
authors.affiliation: Division of Geriatric Psychiatry, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
authors.forename: Diana-Felicia
authors.initials: DF
authors.lastname: Nicolici
authors.affiliation: Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada.
authors.forename: Alva
authors.initials: A
authors.lastname: Tang
authors.affiliation: Department of Geriatrics, College of Medicine, Florida State University, Tallahassee, FL, United States.
authors.forename: Paul
authors.initials: P
authors.lastname: Katz
authors.affiliation: Division of Geriatric Psychiatry, Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Rotman Research Institute, Baycrest, Toronto, ON, Canada; Baycrest Health Sciences Centre, Toronto, ON, Canada. Electronic address: lmah@research.baycrest.org.
authors.forename: Linda
authors.initials: L
authors.lastname: Mah
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000523:psychology*; D005260:Female; D006620:Hip Fractures / Q000523:psychology* / Q000534:rehabilitation*; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D020127:Recovery of Function; D012047:Rehabilitation Centers; D016896:Treatment Outcome
keywords: Aged; Depression; Patient participation; Recreation; Rehabilitation; Treatment outcome