Depressed elderly men have a twofold risk of admission to hospital, found a new study published in CMAJ (Canadian Medical Association Journal). This finding could have potential for helping identify at-risk men to prevent admissions.
"Men with depression had a twofold increase in the mean number of hospital admissions, and these lasted on average twice as long as for men without depression," writes Dr. Matthew Prina, Institute of Public Health, Cambridge University, Cambridge, UK, with coauthors.
Researchers from Australia, the UK and the Netherlands undertook a study of 5411 men aged 69 years and older in Perth, Western Australia, to determine whether hospital admissions were higher for men with depressive symptoms than for those without. To assess whether a patient had depressive symptoms, they used the 15-item Geriatric Depression Scale. Of the 5411 participants, 339 (6.3%) had a score of 7 or greater, indicating moderate to severe depression. Almost half (45%) of the depressed men had at least one emergency admission to hospital compared with 23% (1164 of 5072 nondepressed men). Depressed men were older, less educated, in poorer health with more illnesses and more likely to smoke. Overnight admissions and deaths in hospital were also higher in this group.
The authors suggest several possibilities for higher rates of admission. Depressed patients often do not follow treatment plans and could arrive at hospital with acute illness. Depression may exacerbate chronic diseases and can impede the ability of patients to communicate with their health care providers.
"Even after adjustment for a robust measure of comorbidity...depression was a strong independent risk factor for hospital admission, longer hospital stays and worse hospital outcomes. This suggests that the association between depression and comorbidity, disability and hospital admission is complex and cannot be attributed solely to age, prevalent clinical morbidity, social support, education or smoking," the authors write.
Most previous studies have looked at the impact of depression on specific populations in clinical settings, whereas this study looks at depressed people living in the community. "Few studies have investigated the effect of clinically significant depressive symptoms on hospital admission and outcomes in people living in the community," the authors write.