DEPRESSION IN COMMUNITY-LIVING OLDER ADULTS WITH CHRONIC VENOUS LEG ULCERS

Abstract

Older adults are at higher risk of developing venous leg ulcers, many of which do not heal for months or years. Qualitative reports suggest the chronic condition is associated with poor self-esteem, anxiety and depression; however, there is little information on the prevalence of depressive symptoms, or factors associated with them. Data were collected for 24 weeks from a sample of 386 community-living adults with venous leg ulcers, on socio-demographics, health, and symptoms, utilising the Geriatric Depression Scale (GDS) for depressive symptoms. Multivariable linear regression identified factors associated with depressive symptoms, and logistic regression identified predictors of failure to heal within 24 weeks. The mean age was 79 years (SD 14.4) and 52% were female. On enrolment, 8% (n=29) of participants scored at high risk of depression, and another 23% (n=92) scored at mild risk of depression. Controlling for gender and co-morbidities, regression analysis found younger age (p=0.012), pain (p=0.017) and poorer social support (p=0.001) were significantly associated with higher GDS scores. Higher GDS scores were significantly associated with failure to heal after 24 weeks at the bivariate level (p=0.031), however regression analysis found living alone (OR 2.33, 95%CI 1.37–3.94), rheumatoid arthritis (OR 2.94, 95%CI 1.33–6.67) and weeks of ulcer duration (OR 1.01, 95%CI 1.005–1.014) were the primary predictors of failure to heal (p<0.01). Results suggest that depressive symptoms may not be directly involved in chronic wound healing, rather social factors and management of comorbidities may be significant factors to address to promote well-being and ulcer healing.