Key result
In acute hospitalized patients, depressive symptoms were independently associated with lower IADL scores, female gender, and age, but not comorbidities.
Cross-Sectional (n=1,947)
Yes
Depressive symptoms in acute internal medicine patients are common and associated with loss of autonomy in instrumental activities of daily living rather than worse clinical comorbidities.
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Depressive symptoms may identify IADL impairment risk beyond comorbidities in acute care; cross-sectional data leave causality and interventions open.
There are few data on the prevalence of depression among acute patients with comorbidities. The current study aimed to determine the prevalence of depressive symptoms in hospitalized patients admitted to Internal Medicine Units and the correlation between these symptoms and comorbidities and disability indexes. All consecutive patients admitted to 26 Internal Medicine Units of the Italian National Public Health System in Sicily, Italy, from September 2001 to March 2002 were screened. Within 24 hours of admission, patients were administered the Geriatric Depression Scale (GDS), Mini-Mental State Examination, Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL) and Charlson's Comorbidity Index. 1,947 subjects were included in the analyses. Of the patients, 509 (26.1%) showed depressive symptoms (indicated by GDS score ≥ 15). Depression was significantly associated (univariate analyses) with hypertension (OR 1.45; CI 95% 1.18-1.79), diabetes (OR 1.48, CI 95% 1.17-1.87), cerebrovascular disease (OR 1.50, CI 95% 1.08-2.07), cirrhosis (OR 1.49, CI 95% 1.01-2.19), ADL score (OR 0.72: CI 95% 0.63-0.82), and IADL score (OR 0.83; CI 95% 0.78-0.87), but not with Charlson's Comorbidity Index (OR 1.04; CI 95% 0.98-1.10). Multivariate analysis showed that independent predictive factors for depression were age (OR 1.02, CI 95% 1.01-1.02), female gender (OR 2.29, CI 95% 1.83 - 2.87), and IADL score (OR 0.86, CI 95% 0.81 - 0.93). The data suggest that depressive symptoms are not linked to worse clinical conditions but are associated with the loss of autonomy in Instrumental Activities of Daily Living.
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Carrubba et al. (2011) conducted a cross-sectional in Acute patients with comorbidities (n=1,947). Instrumental Activities of Daily Living (IADL) score was evaluated on Depressive symptoms (GDS score ≥ 15) (OR 0.86, 95% CI 0.81-0.93). In acute hospitalized patients, depressive symptoms were independently associated with lower IADL scores, female gender, and age, but not comorbidities.
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