Depression and mortality in nursing homes.
ABSTRACT To determine the prevalence rates of major depressive disorder and of depressive symptoms and their relationship to mortality in nursing homes, research psychiatrists examined 454 consecutive new admissions and followed them up longitudinally for 1 year. Major depressive disorder occurred in 12.6% and 18.1% had depressive symptoms; the majority of cases were unrecognized by nursing home physicians and were untreated. Major depressive disorder, but not depressive symptoms, was a risk factor for mortality over 1 year independent of selected physical health measures and increased the likelihood of death by 59%. Because depression is a prevalent and treatable condition associated with increased mortality, recognition and treatment in nursing homes is imperative.
- SourceAvailable from: Peter A Lichtenberg[Show abstract] [Hide abstract]
ABSTRACT: This study investigated whether symptoms of depression and cognitive dysfunction predicted all-cause mortality in long-term care (LTC) residents at 12 months after admission. Participants were 171 adults with a mean age of 77 in an urban LTC setting (51% African American and 49% European American). The Geriatric Depression Scale and the Dementia Rating Scale, Second Edition (DRS-2), were administered upon admission, and demographic variables and the Charlson Comorbidity Index were also recorded. Cox regression analyses found that increased depressive symptoms, lower performance on the DRS-2, and European American ethnicity were significant predictors of all-cause mortality. The overall results suggest that the combination of cognitive dysfunction and depressive symptoms can increase the chances of 12-month, all-cause mortality in LTC settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved).Psychology and Aging 06/2010; 25(2):446-52. DOI:10.1037/a0019032 · 2.73 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Depression is a serious mental health problem for older adults. This study examined the effectiveness of an Advanced Practice Psychiatric Nurse (APPN)-Primary Care Physician (PCP) collaborative model to provide care to homebound elders with depressive symptoms. One hundred seventy nine individuals were screened for depression revealing an incidence of 46%. Of these, 83 (46%) were invited to participate in the study based on their depression scores; 41 (49%) agreed to participate in the study. Significant improvement in depression scores occurred for those who received treatment. Treatment included pharmacological and psychosocial interventions. As the population over the age of 65 continues to grow, many more older adults will need mental health treatment, and creative methods to provide services to homebound individuals must be explored.Issues in Mental Health Nursing 10/2008; 29(9):974-91. DOI:10.1080/01612840802279049
- [Show abstract] [Hide abstract]
ABSTRACT: The objectives of this study were to determine the ability of the 30-, 15- and 8-item versions of the GDS for screening and assessing change in severity of depression in nursing home patients. The GDS and the MADRS were administered to 350 elderly NH-patients by trained interviewers. The presence of major (MaD) or minor depression (MinD) was evaluated with the Schedules for Clinical Assessment in Neuropsychiatry. Receiver Operator Characteristic (ROC) curves of the GDS-versions were performed to measure the ability to screen on depression. The ability to measure change in severity of depression was measured by differences in mean GDS-scores and mean MADRS-scores between patients with MaD, MinD and no depression, and expressed in terms of effect sizes. It was found that in ROC-curves all three GDS-versions performed well. The MADRS showed larger effect sizes for the differences between MaD, MinD and no depression than the GDS-versions. The effect sizes of the three GDS versions were comparable. We conclude that all three versions of the GDS can be used for screening on depression among NH-patients. The MADRS is superior to the GDS for assessment of (changes in) severity of depression, but the GDS also appears to be an acceptable instrument for this purpose and is less time-consuming.Aging and Mental Health 04/2008; 12(2):244-8. DOI:10.1080/13607860801987238 · 1.78 Impact Factor