This research investigated the prevalence and course of depression in newly admitted nursing home residents. Representing a departure from the majority of prior research, consecutive admissions were recruited into the study, irrespective of cognitive status. This enabled a comparison of the prevalence and course of depression experienced by cognitively intact residents and those exhibiting all levels of cognitive impairment.
Depression was assessed at 1, 3 and 6 months postadmission. The assessment entailed the conduct of a semistructured clinical interview, which allowed for the provision of DSM-IV diagnoses and the scoring of the Cornell Scale for Depression in Dementia.
Participants were 51 newly admitted residents, drawn from six nursing homes. At admission, nearly 25% of residents were diagnosed with major depression (MD), and a further 20% evidenced a nonmajor depressive disorder. At the second and third assessments, MD was observed in 14% and 15% of residents, respectively. Of particular interest, only the cognitively impaired were diagnosed with MD during the study. For residents who completed all three assessments, there was no appreciable change in the levels of depression apparent.
The current study showed that a great many nursing home residents experience severe depressions that are unlikely to remit spontaneously. Most often, these residents exhibited pronounced cognitive impairment. Accordingly, care staff and GPs must be trained in the identification of depression in dementia, and any interventions implemented in these facilities should be tailored to meet the unique needs of this group.