Major depression in older medical inpatients predicts poor physical and mental health status over 12 months

Abstract

Objective The aim of this study was to determine the 12-month effects upon physical and mental health status of a diagnosis of major or minor depression among older medical inpatients. Methods Patients 65 years and older, admitted to the medical wards of two university-affiliated hospitals, with at most mild cognitive impairment, were screened for major and minor depression ( Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria). All depressed patients and a random sample of nondepressed patients were invited to participate. The physical functioning and mental health subscales of the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) were measured at baseline and at 3, 6 and 12 months. Results Two hundred ten patients completed the SF-36 at baseline and at one or more follow-ups. In multiple linear regression analysis for longitudinal data, adjusting for baseline level of the SF-36 subscale outcome, severity of physical illness, premorbid disability, age, sex and other covariates, patients with major depression at baseline had lower SF-36 scores at follow-up, in comparison to patients with no depression [physical health, 9.22 (95% CI −15.52 to −2.93); mental health, 6.28 (95% CI −11.76 to −0.79)]. Conclusion A diagnosis of major depression in cognitively intact older medical inpatients is associated with sustained poor physical and mental health status over the following 12 months.