Key result
Prior hospitalization, length of stay ≥4 days, angina, and poor social support were associated with a persistent risk of depression, which affected 17% of older cardiac inpatients at 1 month.
Why the study?
What factors are associated with persistent risk of depression in older patients following discharge from an acute cardiac unit?
Cohort (n=155)
What factors are associated with persistent risk of depression in older patients following discharge from an acute cardiac unit?
Persistent depression risk in older cardiac patients is associated with recent prior hospitalization, longer length of stay, angina diagnosis, and poor social support, highlighting targets for post-discharge screening.
May guide targeted post-discharge depression screening in older cardiac patients; hypothesis-generating for interventional trials.
BACKGROUND: This longitudinal study aims to describe the prevalence and characteristics associated with persistent risk of depression in a group of older, hospitalized patients. METHODS: We examined patients at two time-points: baseline and one month post-discharge from hospital. Patients in this study comprised those who had been admitted to the cardiology unit, with no cognitive impairment, aged 60 years and over, and those who were followed up at both time points (N = 155). Questionnaires administered included risk of depression (Geriatric Depression Scale-15; GDS-15), cognitive impairment (Mini-mental State Examination), social support (7-Item Subjective Social Support Index), co-morbidity (Charlson's Comorbidity Index), sociodemographic variables, physical functioning (Modified Barthel's Index) and clinical variables. RESULTS: The prevalence of risk of depression (GDS-15 score > or = 5) among older inpatients at baseline was 34%. At one month post-discharge this had fallen to 17% and this group was identified as those at persistent risk of depression. Factors associated with a risk of persistent depression were: hospitalization within the last six months; length of stay of four days or more; discharge diagnosis of angina; and impaired Subjective Social Support Score. CONCLUSION: Depression occurs commonly among older hospitalized patients and may resolve spontaneously. The identification of factors associated with persistent risk of depression can be helpful when looking at which patients may benefit most from screening and treatment for depression after discharge.
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Hammond et al. (2008) conducted a cohort in Depression in acute cardiac unit patients (n=155). Risk factors (prior hospitalization, length of stay ≥4 days, angina, impaired social support) vs. Patients without these risk factors was evaluated on Persistent risk of depression (GDS-15 score ≥5 at one month post-discharge). Prior hospitalization, length of stay ≥4 days, angina, and poor social support were associated with a persistent risk of depression, which affected 17% of older cardiac inpatients at 1 month.
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