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Depressive Symptoms in Elderly Patients Predict Poor Adjustment After Somatic Events

Received January 2, 2003; revised May 12, May 30, 2003; accepted June 12, 2003. From the Department of Psychiatry, University of Groningen (PdJ,JO), the Department of Internal Medicine, Academic Medical Center, Groningen (JPJS), the Department of Medical Sociology, University of Maastricht (GIJMK), and the Northern Centre for Healthcare Research, Department of Public Health and Health Psychology, University of Groningen (AVR,CHMvJ,WS-K,RS). Send correspondence to P. de Jonge, Ph.D., Department of Psychiatry, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands. e-mail: p.de.jonge{at}med.rug.nl

Objective: The authors tested the hypothesis that elderly subjects with premorbid depressive symptoms are at increased risk of poor adjustment after a somatic event. Methods: The GLAS study contains a baseline assessment and a follow-up of subjects who experienced post-baseline acute myocardial infarction, cancer, congestive heart failure, or fall-related injury of the extremities within 5 years after baseline assessment. Follow-up was conducted at 8 weeks, 6 months, and 1 year after the somatic event. Of a baseline sample of 5,279 elderly subjects (57 and older), 1,124 subjects who experienced one of the specified events were contacted, and sufficient follow-up data were obtained from 558 subjects. Authors analyzed the course of self-reported physical, role, and social functioning, and general health and well-being in subjects without baseline limitations. Patients with poor adjustment after the event were compared with patients with good adjustment on baseline depressive symptoms. They used logistic-regression analysis, controlling for several confounders. Results: In multivariate analyses, pre-event depressive symptoms were associated with an increased risk of poor adjustment in terms of social and role functioning, well-being, and general health, but not physical functioning. Conclusions: Elderly persons living in the community reporting depressive symptoms are at increased risk of poor psychosocial adjustment after a somatic event. Each reported baseline depressive symptom was associated with an increased risk of chronic decline; this finding stresses the importance of detecting and treating depression in community-living elderly persons.

Key Words: Depression • Longitudinal Research • Comorbid Physical Illness • Functional Status

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