Depressive Symptoms After Hospitalization in Older Adults: Function and Mortality Outcomes.
Autor: | Pierluissi, Edgar, Mehta, Kala M., Kirby, Katharine A., Boscardin, W. John, Fortinsky, Richard H., Palmer, Robert M., Landefeld, C. Seth |
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Předmět: |
MORTALITY risk factors
HOSPITAL care of older people APACHE (Disease classification system) CHI-squared test CONFIDENCE intervals MENTAL depression EPIDEMIOLOGY LONGITUDINAL method MEDICAL research personnel MENTAL health surveys NURSES RESEARCH funding STATISTICAL sampling SCALES (Weighing instruments) LOGISTIC regression analysis DATA analysis SECONDARY analysis REPEATED measures design PROPORTIONAL hazards models DATA analysis software DESCRIPTIVE statistics OLD age PSYCHOLOGY |
Zdroj: | Journal of the American Geriatrics Society; Dec2012, Vol. 60 Issue 12, p2254-2262, 9p, 4 Charts, 1 Graph |
Abstrakt: | Objectives To determine the relationship between depressive symptoms after hospitalization and survival and functional outcomes. Design Secondary analysis of a prospective cohort study. Setting General medical service of two urban, teaching hospitals in Ohio. Participants Hospitalized individuals aged 70 and older. Measurements Ten depressive symptoms, instrumental activities of daily living ( IADLs), and basic activities of daily living ( ADLs) were measured at hospital discharge and 1, 3, 6, and 12 months later. Participant-specific changes in depressive symptoms (slopes) were determined using all data points. Four groups were also defined according to number of depressive symptoms (≤3 symptoms, low; 4-10 symptoms, high) at discharge and follow-up: low-low, low-high, high-low, and high-high. Mortality was measured 3, 6, and 12 months after hospital discharge. Results Participant-specific discharge depressive symptoms and change in depressive symptoms over time (slopes) were associated ( P < .05) with functional and mortality outcomes. At 1 year, more participants in the low-low depressive symptom group (49%) were alive and independent in IADLs and ADLs than in the low-high group (37%, P = .02), and more participants in the high-low group (39%) were alive and independent in IADLs and ADLs than in the high-high group (19%, P < .001). Conclusion Number of depressive symptoms and change in number of depressive symptoms during the year after discharge were associated with functional and mortality outcomes in hospitalized older adults. Fewer participants with persistently high or increasing depressive symptoms after hospitalization were alive and functionally independent 1 year later than participants with decreasing or persistently low symptoms, respectively. [ABSTRACT FROM AUTHOR] |
Databáze: | Complementary Index |
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