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Depressive symptoms, physician visits and hospitalization among community-dwelling older adults

Published online by Cambridge University Press:  16 April 2009

Liang Feng ,
Keng Bee Yap ,
Ee Heok Kua  and
Tze Pin Ng
Liang Feng
Affiliation:
Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Gerontological Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Keng Bee Yap
Affiliation:
Gerontological Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Department of Geriatric Medicine, Alexandra Hospital, Singapore
Ee Heok Kua
Affiliation:
Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Gerontological Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Tze Pin Ng*
Affiliation:
Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Gerontological Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
*
Correspondence should be addressed to: Associate Professor Tze-Pin Ng, National University of Singapore, Department of Psychological Medicine, National University Hospital, 5 Lower Kent Ridge Road, Singapore119074. Phone: + 65 67724514; Fax: + 65 67772191. Email: pcmngtp@nus.edu.sg.
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Abstract

Background: The relationship between depressive symptoms and health service use among older people is not well understood. In this study we examined the two-way relationships between depressive symptoms and hospitalization and/or physician visits by older adults.

Methods: In a one-year follow-up study of 973 community-dwelling older adults in the Singapore Longitudinal Aging Studies (SLAS), depressive symptoms (15-item Geriatric Depression Scale score ≥5) were assessed at baseline and one year later. Information on self-reported physician visits and hospitalization were collected bimonthly over one year.

Results: When demographic characteristics, medical comorbidities, functional status and other covariates were controlled for, baseline depressive symptoms were associated with increased episodes of subsequent physician visits during the one-year follow-up (RR,1.34; 95% CI, 1.05–1.70), but not with subsequent hospitalization(s) during the same period. Conversely, participants with five or more physician visits (versus less than 5) over one year were more likely to be depressed at one year (OR, 10.2; 95% CI, 3.36–31.1); hospitalization during this period was also significantly associated with depressive symptoms at one year (OR = 6.43, 95% CI, 2.48–16.6).

Conclusion: Depressive symptoms and health service use have reciprocal relationships. Health service use for non-mental illnesses may be optimized by efforts at post-hospitalization interventions to recognize and treat depression in older persons.

Keywords

depressionphysician visitshospitalization
Type
Research Article
Information
International Psychogeriatrics , Volume 21 , Issue 3 , June 2009 , pp. 568 - 575
Copyright
Copyright © International Psychogeriatric Association 2009

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References

Anttila, S. (1991). Depressive symptoms and general hospital care in the elderly: a population-based study. Nordisk Psykiatrisk Tidsskrift, 45, 345–349.CrossRefGoogle Scholar
Banazak, D. A. (1996). Late-life depression in primary care. Journal of General Internal Medicine, 11, 163–167.CrossRefGoogle ScholarPubMed
Beekman, A. T. F. et al. (2002). The impact of depression on the well being, disability and use of services in older adults: a longitudinal perspective. Acta Psychiatrica Scandinavica, 105, 20–27.CrossRefGoogle ScholarPubMed
de Boer, A. G., Wijker, W. and de Haes, H. C. (1997). Predictors of health care utilization in the chronically ill: a review of the literature. Health Policy, 42, 101–115.CrossRefGoogle ScholarPubMed
DiMatteo, M. R., Lepper, H. S. and Croghan, T. W. (2000). Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Archives of Internal Medicine, 160, 2101–2107.CrossRefGoogle ScholarPubMed
Fischer, L. R. et al. (2002). Geriatric depression, antidepressant treatment, and healthcare utilization in a health maintenance organization. Journal of the American Geriatrics Society, 50, 307–312.CrossRefGoogle Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Ganguli, M., Du, Y., Dodge, H. H., Ratcliff, G. G. and Chang, C. C. (2006). Depressive symptoms and cognitive decline in late life: a prospective epidemiological study. Archives of General Psychiatry, 63, 153–160.CrossRefGoogle ScholarPubMed
Hedayati, S. S. et al. (2005). Physician-diagnosed depression as a correlate of hospitalizations in patients receiving long-term hemodialysis. American Journal of Kidney Diseases, 46, 642–649.CrossRefGoogle ScholarPubMed
Herbert, T. B. and Cohen, S. (1993). Depression and immunity: a meta-analytic review. Psychological Bulletin, 113, 472–486.CrossRefGoogle ScholarPubMed
Huang, B. Y., Cornoni-Huntley, J., Hays, J. C., Huntley, R. R., Galanos, A. N. and Blazer, D. G. (2000). Impact of depressive symptoms on hospitalization risk in community-dwelling older persons. Journal of the American Geriatrics Society, 48, 1279–1284.CrossRefGoogle ScholarPubMed
Jia, H. et al. (2006). The impact of poststroke depression on healthcare use by veterans with acute stroke. Stroke, 37, 2796–2801.CrossRefGoogle ScholarPubMed
Katon, W. and Ciechanowski, P. (2002). Impact of major depression on chronic medical illness. Journal of Psychosomatic Research, 53, 859–863.CrossRefGoogle ScholarPubMed
Koopmans, G. T., Donker, M. C. and Rutten, F. H. (2005). Common mental disorders and use of general health services: a review of the literature on population-based studies. Acta PsychiatricaScandinavica, 111, 341–350.CrossRefGoogle ScholarPubMed
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186.CrossRefGoogle ScholarPubMed
Levinson, C. M. and Druss, B. G. (2005). Health beliefs and depression in a group of elderly high utilizers of medical services. General Hospital Psychiatry, 27,97–99.CrossRefGoogle Scholar
Luber, M. P. et al. (2001). Depression and service utilization in elderly primary care patients. American Journal of Geriatric Psychiatry, 9, 169–176.CrossRefGoogle ScholarPubMed
Mahoney, F. I. and Barthel, D. W. (1965). Functional evaluation: the Barthel Index. Maryland State Medical Journal, 14, 61–65.Google ScholarPubMed
Musselman, D. L., Evans, D. L. and Nemeroff, C. B. (1998). The relationship of depression to cardiovascular disease: epidemiology, biology, and treatment. Archives of General Psychiatry, 55, 580–592.CrossRefGoogle ScholarPubMed
Ng, T. P., Niti, M., Chiam, P. C. and Kua, E. H. (2006). Prevalence and correlates of functional disability in multiethnic elderly Singaporeans. Journal of the American Geriatrics Society, 54, 21–29.CrossRefGoogle ScholarPubMed
Ng, T. P., Niti, M., Chiam, P. C. and Kua, E. H. (2007). Ethnic and educational differences in cognitive test performance on Mini-mental StateExamination inAsians. American Journal of Geriatric Psychiatry, 15, 130–139.CrossRefGoogle Scholar
NIH Consensus Conference (1992). Diagnosis and treatment of depression in late life. JAMA, 268,1018–1024CrossRefGoogle Scholar
Nyunt, M. S. Z., Jin, A. Z., Fones, C. S. L. and Ng, T. P. (in press). Criterion-based validity and reliability of the Geriatric Depression Screening Scale (GDS-15) in a large validation sample of community-living Asian older adults. Aging and Mental Health.Google Scholar
O'Connor, D. W., Rosewarne, R. and Bruce, A. (2001). Depression in primary care. 1: Elderly patients' disclosure of depressive symptoms to their doctors. International Psychogeriatrics, 13, 359–365.CrossRefGoogle ScholarPubMed
Penninx, B. W. et al. (1998). Depressive symptoms and physical decline in community-dwelling older persons.JAMA, 279, 1720–1726.CrossRefGoogle ScholarPubMed
Rugulies, R. (2002). Depression as a predictor for coronary heart disease, a review and meta-analysis. American Journal of Preventive Medicine, 23, 51–61.CrossRefGoogle ScholarPubMed
Schulberg, H. C. et al. (1997). The “usual care” of major depression in primary care practice. Archives of Family Medicine, 6, 334–339.CrossRefGoogle Scholar
Wolinsky, F. D., Culler, S. D., Callahan, C. M. and Johnson, R. J. (1994). Hospital resource consumption among older adults: a prospective analysis of episodes, length of stay, and charges over a seven-year period. Journal of Gerontology, 49, S240–S252.CrossRefGoogle Scholar
Yesavage, J. (1988). Geriatric Depression Scale. Psychopharmacology Bulletin, 24,709–711.Google ScholarPubMed