HOME HELP FEEDBACK SUBSCRIPTIONS ALL ISSUES SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Smalbrugge, M. Articles by Beekman, A. T. F. Search for Related Content PubMed PubMed Citation Articles by Smalbrugge, M. Articles by Beekman, A. T. F.

Incidence and Outcome of Depressive Symptoms in Nursing Home Patients in The Netherlands

From the Department of Nursing Home Medicine, VU University Medical Center, Amsterdam (MS, LJ, AMP, JAE, MWR); Institute of Extramural Medicine (EMGO), VU University Medical Center, Amsterdam (MS, LJ, AMP, JAE, MWR, ATFB); Trimbos-institute, Netherlands Institute of Mental Health and Addiction, Utrecht (AMP); and Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands (ATFB).

Objectives: To assess incidence and outcome of depressive symptoms among nursing home (NH) patients and to identify clinical characteristics predicting onset and persistence of depressive symptoms.

Methods: Depressive symptoms (GDS>10) and relevant correlates were assessed at baseline and at follow-up (6 months) in 350 NH-patients of 14 Dutch NH’s with the Geriatric Depression Scale (GDS). Predictors of onset and persistence were studied using chi-square statistics and multiple logistic regression analyses.

Results: The prevalence of depressive symptoms decreased from 41.3% to 28.9% during six months follow-up. The onset of depressive symptoms in those without depressive symptoms at baseline was 4.7%, while the rate of persistence was 63.3%. Persistence of depressive symptoms was more frequent in patients with higher GDS-scores (18–30) at baseline. No baseline characteristics were associated with onset of depressive symptoms. Persistence of depressive symptoms was only associated with more years of education.

Conclusions: Pre-admission factors and transition may largely be responsible for depressive symptoms among nursing home patients. The observed substantial decrease in prevalence of depressive symptoms over six months is largely due to remission of depressive symptoms present at baseline. Adaptation of nursing home patients to pre-admission factors, facilitated by the nursing home environment, may explain this observed decrease of depressive symptoms. Future studies should evaluate interventions targeted at patients with higher GDS-scores (18–30).

Key Words: Depressive symptoms • incidence • outcome • long-term care • elderly