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Survival in the community of the very old depressed, discharged from medical inpatient care
- Authors:
- WILSON Kenneth, MOTTRAM Patricia, HUSSAIN Maryyum
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(10), October 2007, pp.974-979.
- Publisher:
- Wiley
The aim was to examine the prevalence and associated risk factors of depression in older patients discharged home from acute medical care and their influence on duration of survival in the community. A cross-sectional, prevalence study of depression in recently discharged patients and a prospective, case-controlled study of depressed and psychiatrically asymptomatic sub groups, exploring the relationship between depression, associated risk factors, and duration of survival in the community. A community study of patients aged 75 and older discharged from the Countess of Chester Hospital and Wirral Hospitals Trust serving Wirral and West Cheshire, England. Three hundred and eleven patients were entered into the prevalence study. One hundred and fifty-eight patients (54 depressed and 104 asymptomatic) were entered into the prospective case controlled study and followed up for up to two years. Depression was defined by GMS/AGECAT criteria. Demographic details, handicap, pain, forced expiratory volume and social network were measured as dependent variables in the prevalence study and included in the analysis of risk factors potentially associated with duration of survival in the community. A depression prevalence rate of 17.4% was found. Age, forced expiratory volume and handicap were associated with depression but depression was the only base-line variable associated with reduced survival in the community as defined by mortality and re-admission. Depression is common in older people discharged from acute medical care and is a major risk factor for reduced duration of community survival.
Depressive symptoms in the very old living alone: prevalence, incidence and risk factors
- Authors:
- WILSON Kenneth, MOTTRAM Patricia, SIXSMITH Andrew
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(4), April 2007, pp.361-366.
- Publisher:
- Wiley
Living alone is one of many risk factors associated with depression. This project is nested within the ENABLE-AGE project designed to explore the relationship between housing environment and health in the very old living alone in their own homes. The aim of this specific study is to describe the prevalence, incidence and associated risk factors of clinically significant depressive symptoms in this population with particular emphasis on the role of the home environment. The authors conducted a one year follow up of 376 subjects aged between 80 and 90 years old. Data collected included variables concerned with housing, social circumstances, physical health and psychological well being. A prevalence rate of 21% and an annual incidence of 12.4% (Geriatric Depression Score of five or more) were found. Risk factors associated with prevalence depression include not living close to friends and family, poor satisfaction with living accommodation and poor satisfaction with finances. Subsequent development of clinically significant depressive symptoms was associated with base line increased scores in depression. These results are consistent with findings in the general population of similar age with the exception of considerably higher prevalence and incidence rates. However, the authors were unable to demonstrate that housing related variables were significant risk factors in terms of incidence cases. Older people living alone are particularly vulnerable to depression and may benefit from targeted screening and development of appropriate care pathways.