Abstract
BackgroundLate-life depression is common among elderly patients. Ignorance of the health problem, either because of under-diagnosis or under-treatment, causes additional medical cost and comorbidity. For a better health and quality of life (QoL), evaluation, prevention and treatment of late-life depression in elderly patients is essential.MethodsThis study examined (1) the differences of clinical characteristics, degree of improvement on QoL and functionality on discharge between non-depressed and depressed elderly inpatients and (2) factors associated with QoL on discharge. Four hundred and seventy-one elderly inpatients admitted to a geriatric evaluation and management unit (GEMU) from 2009 to 2010 were enrolled in this study. Comprehensive geriatric assessment including the activities of daily living (ADL), geriatric depression scale, and mini-mental state examination were conducted. QoL was assessed using the European Quality of Life-5 Dimensions and the European Quality of Life-5 Dimensions Visual Analog Scale on discharge. Information on hospital stay and Charlson comorbidity index were obtained by chart review. Chi-square tests, independent t-tests, Mann–Whitney U tests and multiple linear regressions were used in statistical analysis.ResultsWorse QoL and ADL on discharge were found among the depressed. Depressive symptoms, female gender, duration of hospital stay, and rehabilitation were significant factors affecting QoL on discharge in linear regression models.ConclusionsThe importance of the diagnosis and treatment of depression among elderly inpatients should not be overlooked during hospital stay and after discharge. Greater efforts should be made to improve intervention with depressed elderly inpatients.
Highlights
Late-life depression is common among elderly patients
Minimal differences were seen in the sources of referral to the geriatric evaluation and management unit (GEMU) in the two groups (p = 0.042)
Depressed elderly inpatients showed more cognitive impairment and worse activities of daily living (ADL) scores on admission; worse ADL scores and less satisfaction in quality of life (QoL) were shown on discharge (EQ-5D, European quality of life instrument-5 dimensions (EQ-5D)-VAS)
Summary
Late-life depression is common among elderly patients. Ignorance of the health problem, either because of under-diagnosis or under-treatment, causes additional medical cost and comorbidity. For a better health and quality of life (QoL), evaluation, prevention and treatment of late-life depression in elderly patients is essential. Late-life depression (LLD) or geriatric depression is common among elderly [1,2]. Comorbidity is common in LLD, probably arising from biological, psychological and social mechanisms [5]. These include suicidal behavior, decreased in medical settings without mental health facilities [3,4,13]. Inpatients who had depressive symptoms used more hospital and outpatient services than non-depressed counterparts [15]; after discharge, those who had unresolved depressive symptoms had higher rates of clinic visitation and re-hospitalization [16]
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