Prevalence and symptomatology of depression in older people living in institutions in England and Wales
1 Department of Public Health and Primary Care, Cambridge University Forvie Site, Robinson Way, Cambridge CB2 0SR, UK
2 MRC Biostatistics Unit, Forvie Site, Robinson Way, Cambridge CB2 0SR, UK
3 King's College London, Institute of Psychiatry, Section of Epidemiology, London, UK
4 Ullevaal University Hospital, Department of Geriatric Medicine, Oslo, Norway
Address correspondence to: F. A. McDougall. Tel: 01223 763829; Fax: 01223 330330. Email: fm257{at}cam.ac.uk
Background Epidemiological studies have shown that depression is common in institutional settings. However, the symptomatology of depression in this group has not been compared to those living in the community.
Aims To estimate the prevalence of depression and depressive symptomatology in participants living in institutions and compare these to people living in other settings.
Method The Medical Research Council Cognitive Function and Ageing Study (MRC CFAS) is a population-based cohort comprising 13,004 individuals aged 65 and above, from five sites across England and Wales. Following screening, a stratified random sub-sample of 2,640 participants received the Geriatric Mental State (GMS) examination of whom 340 resided in institutions. Diagnoses of depression were made using the Automated Geriatric Examination for Computer-assisted Taxonomy system (AGECAT; [1]).
Results The prevalence of depression in those living in institutions was 27.1% (95% CI 17.8–36.3) compared to 9.3% (95% CI 7.8–10.9) in those living at home. Symptoms relating to depressed mood, severity of illness (e.g. wishing to be dead, future looking bleak) and some non-specific symptoms were more common in those living in residential homes. Depression was significantly associated with younger age (P = 0.002) and high functional disability (P = 0.009) in those living in institutions.
Conclusions Consistent with previous estimates, depression was highly prevalent in institutions, particularly in younger individuals with severe functional impairment. Those in institutions report considerably more symptoms of depression. Finding interventions which address these symptoms might improve quality of life for people in institutions, irrespective of formal diagnoses.
Keywords: depression, prevalence, geriatric psychiatry, homes for the aged, multi-centre study, elderly
Received 7 February 2007; accepted in revised form 23 April 2007.