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Improvement of quality of life in hospitalized depressed elderly

Published online by Cambridge University Press:  18 August 2010

Maria I. Lapid ,
Katherine M. Piderman ,
Susan M. Ryan ,
Kristin J. Somers ,
Matthew M. Clark  and
Teresa A. Rummans
Maria I. Lapid*
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, U.S.A.
Katherine M. Piderman
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, U.S.A.
Susan M. Ryan
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, U.S.A.
Kristin J. Somers
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, U.S.A.
Matthew M. Clark
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, U.S.A.
Teresa A. Rummans
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, U.S.A.
*
Correspondence should be addressed to: Maria I. Lapid, MD, Mayo Clinic, Department of Psychiatry and Psychology, 200 First Street SW, Rochester, MN 55905, U.S.A. Phone: +1 507-255-7184; Fax: +1 507–255-7365. Email: lapid.maria@mayo.edu.
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Abstract

Background: Quality of life is important for all individuals, but is frequently overlooked in psychiatric populations. Our purpose was to assess the quality of life (QOL) of depressed psychiatrically hospitalized elderly patients, examine the association of QOL and depression, and explore any QOL differences related to electroconvulsive therapy (ECT).

Methods: This Institutional Review Board (IRB)-approved prospective study recruited geropsychiatric inpatients aged 65 years and older who were depressed, had Mini-mental State Examination (MMSE) scores >18/30, and adequate communication skills. Surveys were completed upon admission and discharge to measure depression (Hamilton Depression Rating Scale (HDRS)), quality of life (Linear Analogue Scales of Assessment (LASA); Medical Outcomes Short Form-36 Health Survey (SF-36)), cognitive function (MMSE; Executive Interview (EXIT 25)), and coping (Brief COPE Inventory (COPE)). Spearman correlations and Wilcoxon signed rank tests were used to assess changes in measures during hospitalization and relationships among variables.

Results: The 45 study participants who completed the study had a mean age of 74 years. The majority were female (67%), married (58%), Protestant (60%), with at least high school education (78%). Admission scores demonstrated severe depression (HDRS 24.88 ± 10.14) and poor QOL (LASA overall QOL 4.4 ± 2.79, and SF-36 mental [27.68 ± 9.63] and physical [46.93 ± 10.41] component scores). At discharge, there was a significant improvement of depression (HDRS 24.88v12.04, p < 0.0001) and QOL (LASA overall QOL 4.4v6.66, p < 0.0001; and SF-36 mental [27.68v39.10, p < 0.0001] and physical [46.93v50.98, p = 0.003] component scores). Not surprisingly, depression was negatively correlated with overall QOL, mental well-being, physical well-being, and emotional well-being at both admission and discharge. For the group who received ECT, there was a greater magnitude of improvement in SF-36 vitality (p = 0.002) and general health perception (p = 0.04), but also a reduction in EXIT 25 scores at discharge (p = 0.008).

Conclusions: There was improvement of both QOL and depression during the course of hospitalization. Additionally, improvement of QOL was associated with improvement of depression. Perhaps future studies could develop interventions to improve both mood and QOL in elderly depressed inpatients.

Keywords

geriatricdepressionwell-beinginpatientpsychiatric hospitalpsychogeriatricelectroconvulsive therapy
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 3 , April 2011 , pp. 485 - 495
Copyright
Copyright © International Psychogeriatric Association 2010

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