Functional status, symptoms of depression, and the outcomes of hospitalization in community-dwelling elderly patients
N. C. Dunham and M. A. Sager
Department of Preventive Medicine, School of Medicine, University of Wisconsin, Madison.
OBJECTIVE: To assess the relationship between symptoms of depression at
admission and postdischarge medical outcomes in hospitalized elderly
patients. DESIGN: Prospective cohort study. METHODS: Patients screened for
symptoms of depression at admission using the Geriatric Depression Scale
underwent assessment 1 month after discharge to determine outcomes of
hospitalization. SETTING: A 370-bed, acute care, community hospital.
PATIENTS: A sample of 197 cognitively intact, community-dwelling elderly
patients, aged 70 years and older, hospitalized with medical diagnoses,
with expected lengths of stay of 48 hours or more. MAIN OUTCOME MEASURE:
The Medical Outcomes Study Short-Form instrument was used to obtain data on
1-month postdischarge medical outcomes with respect to physical
functioning, health status, and mental status. RESULTS: On admission, a
total of 23.9% had symptoms of depression (Geriatric Depression Scale
score, > or = 11) that were significantly related to preadmission
functional status. In multivariate analyses, depressive symptoms at
admission were significantly related to 1-month medical outcomes,
independent of functional status. CONCLUSIONS: Findings suggest that
depressive symptoms in hospitalized elderly may be reactive to physical
disability and characterize a group of patients who have poorer functional
status prior to admission. The effect of depressive symptoms on 1-month
postdischarge medical outcomes, however, appears to be independent of and
in addition to the effects of preadmission functional status.
