Abstract:
BACKGROUND/OBJECTIVES:Depression screening and treatment for older adults are recommended in Age-Friendly Health Systems. Few studies have evaluated the association between depressive symptoms and postoperative functioning. We aimed to determine the association between varying levels of depressive symptoms in the preoperative setting with postoperative functional recovery. DESIGN:Prospective cohort study. SETTING:Two academic hospitals in Boston, Massachusetts. PARTICIPANTS:Surgical patients aged 70 and older (N = 560). MEASUREMENTS:Participants were assessed preoperatively and 1 year postoperatively. Preoperative evaluation included the 15-item short-form Geriatric Depression Scale (GDS). Results were categorized as low (GDS = 0-1), moderate (2-5), or high (6-15) symptom burden. Primary outcome was 1-year instrumental activities of daily living functional decline. Secondary outcomes included hospital stay longer than 5 days, discharge to post-acute care (PAC) facility, and readmission within 30 days. RESULTS:Mean participant age was 76.6 ± 5 years, 58% were women, 81% underwent an orthopedic operation, 13% gastrointestinal, 6% vascular; 13% had functional decline at 1 year after their operation (by symptom burden: low = 5.5%; moderate = 14.8%, and high = 38.6%). After adjusting for age, sex, and comorbidity, those with moderate or high depressive symptoms demonstrated greater odds of functional decline at 1 year compared with those with a low symptom burden (moderate: adjusted odds ratio [AOR] = 2.7; 95% confidence interval [CI] = 1.3-5.3; high: AOR = 9.3; 95% CI = 4.2-20.6), discharge to PAC facility (moderate: AOR = 1.7; 95%CI = 1.2-2.6; high: AOR = 2.7; 95% CI = 1.4-5.1) but demonstrated no significant association with 30-day readmission or hospital length of stay longer than 5 days. CONCLUSION:Greater burden of preoperative depressive symptoms is associated with increased likelihood of functional decline at 1 year after surgery and of discharge to PAC facility. Preoperative assessment of the burden of depressive symptoms in older adults undergoing elective surgery may be helpful in identifying patients at high risk of poor outcomes.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Tang VL,Cenzer I,McCulloch CE,Finlayson E,Cooper Z,Silvestrini M,Ngo S,Schmitt EM,Inouye SKdoi
10.1111/jgs.16781subject
Has Abstractpub_date
2020-12-01 00:00:00pages
2814-2821issue
12eissn
0002-8614issn
1532-5415journal_volume
68pub_type
杂志文章abstract:OBJECTIVES:To assess the frequency of diagnostic errors in older adults presenting to the emergency department (ED) with symptoms suggestive of Chikungunya virus infection (CVI) and to compare the rates of misdiagnosis of older and younger adults. DESIGN:Cross-sectional study performed in the University Hospitals of M...
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journal_title:Journal of the American Geriatrics Society
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更新日期:2003-08-01 00:00:00
abstract:OBJECTIVES:To assess the prevalence of protocols or guidelines for selected domains of inpatient care for older adults; to explore associations between hospital characteristics and adoption of these guidelines or protocols. DESIGN:Telephone- and Web-based questionnaire. SETTING:General acute care hospitals in Pennsyl...
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doi:10.1111/j.1532-5415.2010.03056.x
更新日期:2010-10-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Journal of the American Geriatrics Society
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更新日期:1992-05-01 00:00:00
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doi:10.1111/j.1532-5415.2009.02639.x
更新日期:2010-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.02104.x
更新日期:2009-02-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
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pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53212.x
更新日期:2005-04-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb06105.x
更新日期:1995-05-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
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更新日期:1994-08-01 00:00:00
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更新日期:2020-10-05 00:00:00
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更新日期:2017-09-01 00:00:00
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更新日期:2015-05-01 00:00:00
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更新日期:2006-12-01 00:00:00
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更新日期:2009-08-01 00:00:00
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更新日期:1995-06-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2016-10-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
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更新日期:2005-12-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16144
更新日期:2019-12-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2001.4930290.x
更新日期:2001-03-01 00:00:00