Hostname: page-component-8448b6f56d-dnltx Total loading time: 0 Render date: 2024-04-25T04:09:21.445Z Has data issue: false hasContentIssue false
  • English
  • Français

Factors associated with persistent risk of depression in older people following discharge from an acute cardiac unit

Published online by Cambridge University Press:  01 August 2008

A. J. Hammond ,
S. Yu ,
K. Esa ,
J. Jabbour ,
L. Wakefield ,
P. Ryan  and
R. Visvanathan
A. J. Hammond
Affiliation:
Discipline of Public Health, University of Adelaide, Adelaide, South Australia, Australia
S. Yu
Affiliation:
Aged and Extended Care Service, The Queen Elizabeth Hospital, Woodville Road, Adelaide, South Australia, Australia
K. Esa
Affiliation:
Aged and Extended Care Service, The Queen Elizabeth Hospital, Woodville Road, Adelaide, South Australia, Australia
J. Jabbour
Affiliation:
Aged and Extended Care Service, The Queen Elizabeth Hospital, Woodville Road, Adelaide, South Australia, Australia
L. Wakefield
Affiliation:
Aged and Extended Care Service, The Queen Elizabeth Hospital, Woodville Road, Adelaide, South Australia, Australia
P. Ryan
Affiliation:
Discipline of Public Health, University of Adelaide, Adelaide, South Australia, Australia
R. Visvanathan*
Affiliation:
Aged and Extended Care Service, The Queen Elizabeth Hospital, Woodville Road, Adelaide, South Australia, Australia Discipline of Medicine, Department of Medicine, University of Adelaide, South Australia, Australia
*
Correspondence should be addressed to: Associate Professor Renuka Visvanathan, Director of Aged and Extended Care Service, The Queen Elizabeth Hospital, 28 Woodville Road, Woodville South, SA 5011. Phone: +61 8 8222 8594; Fax: +61 8 8222 8593. Email: renuka.visvanathan@adelaide.edu.au.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: This longitudinal study aims to describe the prevalence and characteristics associated with persistent risk of depression in a group of older, hospitalized patients.

Methods: We examined patients at two time-points: baseline and one month post-discharge from hospital. Patients in this study comprised those who had been admitted to the cardiology unit, with no cognitive impairment, aged 60 years and over, and those who were followed up at both time points (N = 155). Questionnaires administered included risk of depression (Geriatric Depression Scale-15; GDS-15), cognitive impairment (Mini-mental State Examination), social support (7-Item Subjective Social Support Index), co-morbidity (Charlson's Comorbidity Index), sociodemographic variables, physical functioning (Modified Barthel's Index) and clinical variables.

Results: The prevalence of risk of depression (GDS-15 score ≥ 5) among older inpatients at baseline was 34%. At one month post-discharge this had fallen to 17% and this group was identified as those at persistent risk of depression. Factors associated with a risk of persistent depression were: hospitalization within the last six months; length of stay of four days or more; discharge diagnosis of angina; and impaired Subjective Social Support Score.

Conclusion: Depression occurs commonly among older hospitalized patients and may resolve spontaneously. The identification of factors associated with persistent risk of depression can be helpful when looking at which patients may benefit most from screening and treatment for depression after discharge.

Keywords

ageddepressionrisk factorshospitalization
Type
Research Article
Information
International Psychogeriatrics , Volume 20 , Issue 4 , August 2008 , pp. 738 - 751
Copyright
© International Psychogeriatric Association 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Arnold, N. and Kafetz, K. (2002). Elderly medical inpatients screening positive for depression may show spontaneous improvement after discharge. Age and Ageing, 31, 397–400.CrossRefGoogle ScholarPubMed
Berkman, L. F. et al. (2003). Effects of treating depression and low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Randomized Trial. JAMA, 289, 3106–3116. DOI: 10.1001/jama.289.23.3106.Google ScholarPubMed
Calver, J., Brameld, K. J., Preen, D. B., Alexia, S. J., Boldy, D. P. and McCaul, K. A. (2006). High-cost users of hospital beds in Western Australia: a population-based record linkage study. Medical Journal of Australia, 184, 393–397.CrossRefGoogle ScholarPubMed
Charlson, M. and Peterson, J. C. (2002). Medical comorbidity and late life depression: what is known and what are the unmet needs? Biological Psychiatry, 52, 226–235. DOI: 10.1016/S0006-3223(02)01422-1.CrossRefGoogle ScholarPubMed
Charlson, M. E., Pompei, P., Ales, K. L. and MacKenzie, C. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of Chronic Diseases, 40, 373–383.CrossRefGoogle ScholarPubMed
Creed, F., Morgan, R., Fiddler, M., Marshall, S., Guthrie, E. and House, A. (2002). Depression and anxiety impair health-related quality of life and are associated with increased costs in general medical inpatients. Psychosomatics, 43, 302–309.CrossRefGoogle ScholarPubMed
Dickens, C. et al. (2005). Association between depressive episode before first myocardial infarction and worse cardiac failure following infarction. Psychosomatics, 46, 523–528. DOI:10.1176/appi.psy.46.6.523.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Fulop, G., Strain, J. J. and Stettin, G. (2003). Congestive heart failure and depression in older adults: clinical course and health services use 6 months after hospitalization. Psychosomatics, 44, 367–373.CrossRefGoogle ScholarPubMed
Glassman, A. H. and BiggerJ. T., Jr. J. T., Jr. (2007). Antidepressants in coronary heart disease: SSRIs reduce depression, but do they save lives? JAMA, 297, 411–412. DOI: 10.1001/jama.297.4.411.CrossRefGoogle ScholarPubMed
Koenig, H. G., Westlund, R. E., George, L. K., Hughes, D. C., Blazer, D. G. and Hybels, C. (1993). Abbreviating the Duke Social Support Index for use in chronically ill elderly individuals. Psychosomatics, 34, 61–69.CrossRefGoogle ScholarPubMed
Koponen, H. J. et al. (2007). Rates and previous disease history in old age suicide. International Journal of Geriatric Psychiatry, 22, 38–46. DOI: 10.1002/gps.1651.CrossRefGoogle ScholarPubMed
Kronish, I. M. et al. (2006). Persistent depression affects adherence to secondary prevention behaviors after acute coronary syndromes. Journal of General Internal Medicine, 21, 1178–1183. DOI:10.1111/j.1525-1497.2006.00586.x.CrossRefGoogle ScholarPubMed
Landerman, R., George, L. K., Campbell, R. T. and Blazer, D. G. (1989). Alternative models of the stress buffering hypothesis. American Journal of Community Psychology, 17, 625–642. DOI: 10.1007/BF00922639.CrossRefGoogle ScholarPubMed
Lebret, S., Perret-Vaille, E., Mulliez, A., Gerbaud, L. and Jalenques, I. (2006). Elderly suicide attempters: characteristics and outcome. International Journal of Geriatric Psychiatry, 21, 1052–1059. DOI: 10.1002/gps.1605.CrossRefGoogle Scholar
Lesman-Leegte, I., Jaarsma, T., Sanderman, R., Linssen, G. and van Veldhuisen, D. J. (2006). Depressive symptoms are prominent among elderly hospitalised heart failure patients. European Journal of Heart Failure, 8, 634–640. DOI: 10.1016/j.ejheart.2005.11.010.CrossRefGoogle ScholarPubMed
Müller-Thomsen, T., Arlt, S., Mann, U., Mass, R. and Ganzer, S. (2005). Detecting depression in Alzheimer's disease: evaluation of four different scales. Archives of Clinical Neuropsychology, 20, 271–276. DOI: 10.1016/j.acn.2004.03.010.CrossRefGoogle ScholarPubMed
Penninx, B. W. et al. (2001). Depression and cardiac mortality: results from a community-based longitudinal study. Archives of General Psychiatry, 58, 221–227.CrossRefGoogle ScholarPubMed
Powers, J. R., Goodger, B. and Byles, J. E. (2004). Assessment of the abbreviated Duke Social Support Index in a cohort of older Australian women. Australasian Journal on Ageing, 23, 71–76. DOI: 10.1111/j.1741-6612.2004.00008.x.CrossRefGoogle Scholar
Reinhardt, J. P., Boerner, K. and Horowitz, A. (2006). Good to have but not to use: differential impact of perceived and received support on well-being. Journal of Social and Personal Relationships, 23, 117–129. DOI: 10.1177/0265407506060182.CrossRefGoogle Scholar
Rieckmann, N. et al. (2006). Persistent depressive symptoms lower aspirin adherence after acute coronary syndromes. American Heart Journal, 152, 922–927. DOI: 10.1016/j.ahj.2006.05.014.CrossRefGoogle ScholarPubMed
Schrader, G., Cheok, F., Hordacre, A. L. and Marker, J. (2006). Predictors of depression 12 months after cardiac hospitalization: the Identifying Depression as a Comorbid Condition study. Australian and New Zealand Journal of Psychiatry, 40, 1025–1030. DOI: 10.1111/j.1440-1614.2006.01927.Google ScholarPubMed
Shah, S., Vanclay, F. and Cooper, B. (1989). Improving the sensitivity of the Barthel Index for stroke rehabilitation. Journal of Clinical Epidemiology, 42, 703–709.CrossRefGoogle ScholarPubMed
Sheikh, J. I. and Yesavage, J. A. (1986). Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. In: Brink, T. L. (ed.), Clinical Gerontology: A Guide to Assessment and Intervention (pp. 165–173). New York: The Haworth Press.Google Scholar
Spijkerman, T. A., van den Brink, R. H., Jansen, J. H., Crijns, H. J. and Ormel, J. (2005). Who is at risk of post-MI depressive symptoms? Journal of Psychosomatic Research, 58, 425–432; discussion 433–424.CrossRefGoogle ScholarPubMed
Vanderhorst, R. K. and McLaren, S. (2005). Social relationships as predictors of depression and suicidal ideation in older adults. Aging and Mental Health, 9, 517–525. DOI: 10.1080/13607860500193062.CrossRefGoogle ScholarPubMed
Wancata, J., Alexandrowicz, R., Marquart, B., Weiss, M. and Friedrich, F. (2006). The criterion validity of the Geriatric Depression Scale: a systematic review. Acta Psychiatrica Scandinavica, 114, 398–410. DOI:10.1111/j.1600-0447.2006.00888.x.CrossRefGoogle ScholarPubMed