Regular Research ArticlesRates of Clinical Depression Diagnosis, Functional Impairment, and Nursing Home Placement in Coexisting Dementia and Depression
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METHODS
This was a 1-year prospective study comparing outcomes among elderly subjects with either depression alone, dementia alone, or coexisting dementia and depression. Subjects were recruited sequentially from inpatient (medical/surgical and psychiatric units) and outpatient (both primary and specialty clinic) settings at the Veterans Affairs Ann Arbor Healthcare System, between 1998 and 2000, and screened using both the Geriatric Depression Scale (GDS)11 and the Mini-Mental State Exam (MMSE).12
Demographic Characteristics
Table 1 presents sociodemographic characteristics of the subjects in the three study groups. There were no significant demographic differences between study groups except mean age and level of medical burden. DEM and CDD subjects were significantly older than DEP subjects. DEP subjects had significantly higher baseline and follow-up medical burden than DEM subjects.
In terms of mortality, 18.5% of the DEP group (N = 5), 15.4% of the DEM group (N = 4), and 31.0% of the CDD (N = 9) group died
DISCUSSION
The findings of this prospective study confirm the results of our earlier retrospective study that patients with coexisting dementia and depression have significantly higher rates of nursing home placement than patients with either depression or dementia alone. Eventual nursing home placement during the 12-month follow-up was significantly correlated with baseline functional impairment and dementia mood scores but not with other factors, such as physical illness burden or dementia stage. Also,
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This work was presented in part at the American Association for Geriatric Psychiatry 14th Annual Meeting, San Francisco, CA, February 23–26, 2001.
We thank Betty Bigger for her dedicated efforts in the recruitment of study subjects.
This research was supported by: a pilot grant from the University of Michigan Geriatrics Center/Institute of Gerontology; the Rachel Upjohn Clinical Scholars Program at the University of Michigan; the Geriatric Research Education and Clinical Center, the VA Ann Arbor Healthcare System; and the VA HSR&D Career Development Program.