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Depression and Its Relationship to Function and Medical Status, By Dementia Status, in Nursing Home Admissions

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Objective

To determine rates of depression by dementia status in a statewide sample of nursing home admissions, and associations with medical comorbidity and physical functioning.

Methods

Trained interviewers obtained information from nursing home residents, staff, significant others, and medical records.

Results

A total of 22.3% were classified depressed in the nondemented status and 23.6% in the demented status. Depression status was significantly associated with more physical dependencies regardless of dementia status. In the nondemented, there was also a significant positive association with number of comorbidities. One interaction, dementia with comorbidity at the highest levels of comorbidity, was significant in looking at association with depression.

Conclusion

There is significant depressive symptomatology in nursing home admissions, which is also associated with difficulty in physical function and with the number of medical comorbidities in the nondemented. Application of the two measures used in this study represents a strategy to assess depression in all nursing home residents.

Section snippets

METHODS

Subjects were recruited from a stratified random sample of 59 nursing homes in Maryland. Details of methodology are reported elsewhere.7 Briefly, new admissions from September 1992 through March 1995 aged 65 years and older who had not been a resident of a nursing home in the previous year were eligible for inclusion in the study. Nondemented subjects provided their own consent; significant others provided consent for residents not able to provide it due to cognitive or other limitations. Data

RESULTS

Categorizing by age group, 20% of the sample were 65–74 years, 43% were 75–84 years, and 37% were 85+ years. Males comprised 30% of the sample. For race/ethnicity, 80% were white, non-Hispanic; 16.5% were African-American; and 2.5% were Hispanic. In terms of education, 31% had 0–8 years of schooling, 44% had 9–12 years, and 25% had more than 12 years of school. Twenty percent were married.

Table 1 shows rates of depression by dementia status, and rates of depression (by dementia status)

DISCUSSION

This study found significant depressive symptomatology among a statewide sample of newly admitted nursing home residents; approximately 23% experienced significant depressive symptoms. This finding corroborates that of other studies, such as that of Payne et al., which found 19.9% of long-term care admissions with dementia to have significant depressive symptoms.3

This study also demonstrates a relationship between report of depressive symptoms and the co-occurrence of difficulty in performance

References (19)

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This research was supported by a grant from the National Institute on Aging, RO1 AG08211 and R29 AG11407.

This work was presented at the 51st Annual Scientific Meeting of the Gerontological Society of America, Philadelphia, PA, November 1998.

The authors acknowledge the cooperation of the facilities, residents, and families participating in the University of Maryland Long-Term Care Project.

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