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Depression in the first year of stay for elderly long-term nursing home residents in the U.S.A.

Published online by Cambridge University Press:  18 May 2010

D. R. Hoover ,
M. Siegel ,
J. Lucas ,
E. Kalay ,
D. Gaboda ,
D. P. Devanand  and
S. Crystal
D. R. Hoover*
Affiliation:
Institute for Health, Health Care Policy and Aging Research; Rutgers, The State University of New Jersey, New Brunswick, NJ, U.S.A. Department of Statistics and Biostatistics; Rutgers, The State University of New Jersey, New Brunswick, NJ, U.S.A.
M. Siegel
Affiliation:
Institute for Health, Health Care Policy and Aging Research; Rutgers, The State University of New Jersey, New Brunswick, NJ, U.S.A.
J. Lucas
Affiliation:
Institute for Health, Health Care Policy and Aging Research; Rutgers, The State University of New Jersey, New Brunswick, NJ, U.S.A.
E. Kalay
Affiliation:
Institute for Health, Health Care Policy and Aging Research; Rutgers, The State University of New Jersey, New Brunswick, NJ, U.S.A.
D. Gaboda
Affiliation:
Institute for Health, Health Care Policy and Aging Research; Rutgers, The State University of New Jersey, New Brunswick, NJ, U.S.A.
D. P. Devanand
Affiliation:
Division of Geriatric Psychiatry College of Physicians and Surgeons, Columbia University New York, NY, U.S.A.
S. Crystal
Affiliation:
Institute for Health, Health Care Policy and Aging Research; Rutgers, The State University of New Jersey, New Brunswick, NJ, U.S.A.
*
Correspondence should be addressed to: Professor Donald R. Hoover, Department of Statistics and Biostatistics, Rutgers, The State University of New Jersey, 30 College Avenue, New Brunswick, NJ 08901, U.S.A. Phone: +1 732-932-6939, Fax: +1 732-932-6872. Email: drhoover@stat.rutgers.edu.
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Abstract

Background: Understanding the prevalence, incidence and cofactors of depression among long-term elderly nursing home (LTNH) residents domiciled for eight months or more may help optimize depression treatment in this vulnerable group. We quantified first year depression in American LTNH residents and the associations between depression and resident/facility characteristics.

Methods: Data were obtained from the Minimum Data Set and Online Survey Certification and Reporting for 634,060 LTNH residents admitted from 1999 to 2005 in 4,216 facilities. Depression first diagnosed at admission and at subsequent quarterly intervals through the first year of stay was examined. Logistic regressions modeled correlates of newly identified depression in each time-period.

Results: Recorded depression at admission and during the first year increased from 1999 to 2005. By 2005, 54.4% of LTNH residents had depression diagnosed over the first year; 32.8% at admission and a further 21.6% later during the first year. Antidepressant use was reported prior to depression diagnosis for 48% of those first identified depressed after admission. Men, non-Hispanic blacks, never married, and severely-cognitively impaired LTNH residents were less often identified with depression, particularly at admission. Pain and physical comorbidity were positively associated with depression identified throughout the first year. Prior institutionalization was associated with depression at admission, but not new depression after admission. Facility characteristics had weaker associations with depression.

Conclusions: High depression rates at admission and during the first year indicate a need to monitor and treat large numbers of American LTNH residents for depression. Reduced associations between demographics and depression as stays progress suggest other factors have increased roles in depression etiology.

Keywords

depressionincidencenursing homespredictorslong-term care
Type
Research Article
Information
International Psychogeriatrics , Volume 22 , Special Issue 7: Focus on mental health issues in long-term-care homes , November 2010 , pp. 1161 - 1171
Copyright
Copyright © International Psychogeriatric Association 2010

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