Some predictors of mortality in acutely medically ill elderly inpatients.

Abstract

The prevalence of depression and suicidal ideation in acutely medically ill elderly inpatients is high. Depression and suicidal ideation are associated with increased mortality. The following were examined among acutely medically ill elderly inpatients: the association between mortality at 6-8 month follow-up period and Brief Assessment Scale (BAS-DEP) depression caseness and scores, using BAS-DEP items of 'a wish to die', 'pessimism' and 'life not worth living', functional disability measured by the London Handicap Scale (LHS) and the Barthel Index (BI), suicidal ideation measured by the Beck Suicidal Ideation Scale (BSSI), severity of physical illness, previous deliberate self-harm and demographic variables. On univariate analysis, significant associations between mortality and being married, previous deliberate self-harm, higher scores on the BAS-DEP item of pessimism, lower scores on the LHS and the BI and higher scores on the BSSI were observed. On multivariate analysis only LHS scores and BSSI scores independently predicted mortality. It is hypothesized that suicidal ideation and functional disability may have a causal effect on mortality. This hypothesis could be tested by early identification of suicidal ideation and/or functional disability and subsequent interventions specifically designed to improve these two facets using a randomized controlled design.