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Age and Ageing 2008 37(6):690-695; doi:10.1093/ageing/afn193
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© The Author 2008. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Does depression predict adverse outcomes for older medical inpatients? A prospective cohort study of individuals screened for a trial*

Sarah Cullum1, Chris Metcalfe2, Chris Todd3 and Carol Brayne4

1 Division of Psychiatry, Cotham House, Cotham Hill, Bristol BS6 6JL, UK
2 Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK
3 School of Nursing, Midwifery and Social Work, University Place, University of Manchester, Oxford Road, Manchester M13 9PL, UK
4 Department of Public Health & Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge, CB2 2SR, UK

Address correspondence to: Sarah Cullum, Division of Psychiatry, Cotham House, Cotham Hill, Bristol BS6 6JL, UK. Email: sarah.cullum{at}awp.nhs.uk

Objective: to examine the relationship between depressive symptoms and hospital outcomes in an unselected consecutive sample of older medical inpatients.

Design: a prospective cohort study of individuals screened for a trial.

Setting: medical wards of UK district general hospital in rural East Anglia.

Participants: six hundred and seventeen medical inpatients aged 65+ were randomly selected from consecutive admissions.

Baseline measures: 15-item Geriatric Depression Scale (GDS-15), the Abbreviated Mental Test Score (AMTS) and the Cumulative Illness Rating Scale—Geriatric (CIRS-G).

Main outcome measures: length of hospital stay; discharge to a community hospital (for rehabilitation), institutional care or usual place of residence; dying in hospital.

Results: depressive symptoms are independently associated with an increased likelihood of inpatient death and transfer to a community hospital for rehabilitation, but are not associated with longer length of stay.

Conclusions: research evaluating effectiveness of identification and treatment of depression in older medical inpatients should consider including inpatient death and use of rehabilitation services as potential outcomes.

Keywords: depression, aged, inpatients, cohort study, elderly

* This work was performed at West Suffolk Hospital and Department of Public Health and Primary Care, University of Cambridge.

Received 11 August 2007; accepted in revised form 5 September 2008.


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