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Depression and Physical Disability Outcomes in Depressed Medically Ill Hospitalized Older Adults

Received May 22, 1997; accepted October 8, 1997. From the Duke University Medical Center, Durham, North Carolina. Address correspondence to Dr. Koenig, Duke University Medical Center, Box 3400, Durham, NC 27710.

The authors examined depression/disability outcomes in hospitalized older medical patients during the year after hospital discharge to assess the pattern and rate of changing depression and disability, the causal relationship between these variables, and to identify patients at greatest risk for poor outcomes. A group of 119 medical patients at Duke Hospital were both depressed and disabled; they were followed for a median of 47 weeks after hospital discharge. Time-series analyses showed that depression and disability tended to track together, and most changes occurred within the first 6 months after discharge. Blacks were more likely to remit from depression despite continued disability and less likely to experience continued depression despite decreased disability. Patients with a history of depression were less likely to experience improvement in depression unless disability improved. Number of medical diagnoses and depression severity independently predicted poorer depression outcomes. Certain characteristics of patients during hospitalization predict depression/disability outcomes after discharge.

Key Words: Depression • Physical Disability • Medical Illness

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