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Trajectories of cognitive-affective depressive symptoms in acutely hospitalized older adults: The hospital-ADL study.

Abstract：

OBJECTIVE:To identify trajectories of cognitive-affective depressive symptoms among acutely hospitalized older patients and whether trajectories are related to prognostic baseline factors and three-month outcomes such as functional decline, falls, unplanned readmissions, and mortality. METHODS:Prospective multicenter cohort of acutely hospitalized patients aged ≥ 70. Depressive trajectories were based on Group Based Trajectory Modeling, using the Geriatric Depression Scale-15. Outcomes were functional decline, falls, unplanned readmission, and mortality within three months post-discharge. RESULTS:The analytic sample included 398 patients (mean age = 79.6 years; SD = 6.6). Three distinct depressive symptoms trajectories were identified: minimal (63.6%), mild persistent (25.4%), and severe persistent (11.0%). Unadjusted results showed that, compared to the minimal symptoms group, the mild and severe persistent groups showed a significantly higher risk of functional decline (mild: OR = 3.9, p < .001; severe: OR = 3.0, p = .04), falls (mild: OR = 2.0, p = .02; severe: OR = 6.0, p < .001), and mortality (mild: OR = 2.2, p = .05; severe: OR = 3.4, p = .009). Patients with mild or severe persistent symptoms were more malnourished, anxious, and functionally limited and had more medical comorbidities at admission. CONCLUSION:Nearly 40% of the acutely hospitalized older adults exhibited mild to severe levels of cognitive-affective depressive symptoms. In light of the substantially elevated risk of serious complications and the fact that elevated depressive symptoms was not a transient phenomenon identification of these patients is needed. This further emphasizes the need for acute care hospitals, as a point of engagement with older adults, to develop discharge or screening procedures for managing cognitive-affective depressive symptoms.

journal_name

J Psychosom Res

journal_title

Journal of psychosomatic research

authors

Reichardt LA,van Seben R,Aarden JJ,van der Esch M,van der Schaaf M,Engelbert RHH,Twisk JWR,Bosch JA,Buurman BM,Hospital-ADL study group.

doi

10.1016/j.jpsychores.2019.03.011

subject

Has Abstract

pub_date

2019-05-01 00:00:00

pages

66-73

eissn

0022-3999

issn

1879-1360

pii

S0022-3999(18)31011-0

journal_volume

120

pub_type

杂志文章

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