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Does depression predict adverse outcomes for older medical inpatients? A prospective cohort study of individuals screened for a trial.
Cullum S, Metcalfe C, Brayne C, Todd C
Age and Ageing. 2008;37:690-695.
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Abstract
Objective: to examine the relationship between depressive symptoms and hospital outcomes in an unselected consecutive sample of older medical inpatients. Design: a prospective cohort study of individuals screened for a trial. Setting: medical wards of UK district general hospital in rural East Anglia. Participants: six hundred and seventeen medical inpatients aged 65+ were randomly selected from consecutive admissions. Baseline measures: 15-item Geriatric Depression Scale (GDS-15), the Abbreviated Mental Test Score (AMTS) and the Cumulative Illness Rating Scale—Geriatric (CIRS-G). Main outcome measures: length of hospital stay; discharge to a community hospital (for rehabilitation), institutional care or usual place of residence; dying in hospital. Results: depressive symptoms are independently associated with an increased likelihood of inpatient death and transfer to a community hospital for rehabilitation, but are not associated with longer length of stay. Conclusions: research evaluating effectiveness of identification and treatment of depression in older medical inpatients should consider including inpatient death and use of rehabilitation services as potential outcomes.