Impact of psychiatric disorders on the outcome of acute geriatric inpatient treatment: an exploratory investigation

Abstract

Systematic study results of geriatric inpatient treatment assessing the impact of psychiatric disorders on treatment outcome are so far missing. This exploratory study investigated the impact of dementia, depression and delirium on treatment outcome in ageriatric department, compared to those individuals without psychiatric symptoms at the beginning of treatment. From January to June 2018 treatment data from geriatric inpatient records were retrospectively evaluated. Functional measurements (Barthel index, timed up and go test, Tinetti test and the De Morton mobility index) were assessed at the start of geriatric treatment and at discharge. A multivariate variance analysis (MANOVA) was used to calculate the possible impact of psychiatric disorders on functional improvement during treatment and to find out if there were significant differences between the four defined groups (dementia, depression, delirium and mentally sound). A total of 280 geriatric inpatients with an average age of 84years, were included in this study and showed anoticeable prevalence of psychiatric disorders: dementia 29%, depression 27%, and delirium 15%. As expected, the patients in the sample showed ahigh level of multimorbidity and polypharmacy. Functional improvement was present in each of the defined groups and significant differences between all groups were found. The results of MANOVA showed that none of the possible confounding variables, e.g. age, mini mental status examination (MMSE), degree of care, cognitive impairment, social status, gender and comorbid illness, had an important influence on the group results. This study of an acute geriatric department demonstrated that psychiatric disorders in these multimorbid, aged patients did not prevent functional improvement by treatment, showed significant differences during the course of treatment and outcome and compared to inpatients without psychiatric symptoms.