Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-18T22:25:33.188Z Has data issue: false hasContentIssue false

Depression among newly admitted Australian nursing home residents

Published online by Cambridge University Press:  01 August 2008

K. McSweeney*
Affiliation:
Aged Mental Health Research Unit, School of Psychology, Psychiatry and Psychological Medicine, Monash University, Victoria, Australia
D. W. O'Connor
Affiliation:
Aged Mental Health Research Unit, School of Psychology, Psychiatry and Psychological Medicine, Monash University, Victoria, Australia
*
Correspondence should be addressed to: K. McSweeney, Research Fellow, Aged Mental Health Research Unit, School of Psychology, Psychiatry and Psychological Medicine, Monash University, Kingston Centre, Warrigal Road, Cheltenham, Victoria, Australia3192. Phone: +61 3 9265 1715; Fax: +61 3 9265 1711. Email: [email protected].
Get access

Abstract

Background: This research concerns the prevalence and course of depression in newly admitted nursing home residents. We attempted to recruit consecutive admissions into the study, irrespective of cognitive status, enabling a comparison of the prevalence and course of depression experienced by cognitively intact residents and those exhibiting all levels of cognitive impairment.

Method: Depression was assessed at one month, three months and six months post-admission. The assessment of mood in this study entailed the conduct of a semi-structured clinical interview, which encompassed DSM-IV criteria and Cornell Scale for Depression in Dementia (CSDD) items.

Results: Recruitment difficulties resulted in a sample of 51 newly admitted residents, drawn from six nursing homes located in Victoria, Australia. Of particular interest, throughout the duration of the study, only the cognitively impaired were diagnosed with major depression (MD). One month post-admission, 24% of the sample were diagnosed with MD, and a further 20% evidenced a non-major depressive disorder. At the second and third assessments, MD was observed in 14% and 15% of residents, respectively. For residents who completed all three assessments, there was no appreciable change in the proportion diagnosed with a depressive disorder, nor was there a change in the levels of depressive symptomatology.

Conclusion: Although subject to limitations, the current study indicated that clinical depression in nursing home facilities most often occurs in residents who also exhibit pronounced cognitive impairment. These depressions are unlikely to remit spontaneously. Accordingly, care staff and general practitioners 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.

Type
Research Article
Copyright
© International Psychogeriatric Association 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alexopoulos, G. S., Abrams, R. C., Young, R. C. and Shamoian, C. A. (1998a). Cornell Scale for Depression in Dementia. Biological Psychiatry, 23, 271284.Google Scholar
Alexopoulos, G. S., Abrams, R. C., Young, R. C. and Shamoian, C. A. (1988b). Use of the Cornell Scale in nondemented patients. Journal of the American Geriatrics Society, 36, 230236.Google Scholar
Ambo, H. et al. (2001). Depressive symptoms and associated factors in a cognitively normal elderly population: the Tajiri Project. International Journal of Geriatric Psychiatry, 16, 780788.Google Scholar
Ames, D., Ashby, D., Mann, A. H. and Graham, N. (1988). Psychiatric illness in elderly residents of Part III homes in one London borough: prognosis and review. Age and Ageing, 17, 249256.Google Scholar
Australian Institute of Health and Welfare (2004). Residential Aged Care in Australia 2002–03: A statistical Overview. AIHW Cat. No. AGE38. Canberra: Australian Institute of Health and Welfare.Google Scholar
Draper, B. M. (1999). The diagnosis and treatment of depression in dementia. Psychiatric Services, 50, 11511153.Google 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, 189198.Google Scholar
Folstein, M. F., Folstein, S. E., McHugh, P. R. and Fanjing, G. (2001). Mini-mental State Examination: User's Guide. Florida: Psychological Assessment Resources.Google Scholar
Katz, I. R., Lesher, E., Kleban, M., Jethanandan, V. and Parmelee, P. (1989). Clinical features of depression in the nursing home. International Psychogeriatrics, 1, 515.Google Scholar
Lyketsos, C. G. et al. (2003). Treating depression in Alzheimer's Disease: efficacy and safety of sertraline therapy, and the benefits of depression reduction: the DIADS. Archives of General Psychiatry, 60, 737746.Google Scholar
Magai, C., Kennedy, G., Cohen, C. I. and Gomberg, D. (2000). A controlled clinical trial of sertraline in the treatment of depression in nursing home patients with late-stage Alzheimer's disease. American Journal of Geriatric Psychiatry, 8, 6674.Google Scholar
McCabe, M. P., Davison, T., Mellor, D., Kuruvilla, G., Moore, K. and Ski, C. (2006). Depression among older people with cognitive impairment: prevalence and detection. International Journal of Geriatric Psychiatry, 21, 633644.CrossRefGoogle ScholarPubMed
Nyth, A. L. et al. (1992). A controlled multicenter clinical study of citalopram and placebo in elderly depressed patients with and without concomitant dementia. Acta Psychiatrica Scandinavica, 86, 138145.Google Scholar
O'Connor, D. W. et al. (1989). The reliability and validity of the Mini-mental State in a British community survey. Journal of Psychiatric Research, 23, 8796.Google Scholar
Parmelee, P. A., Katz, I. R. and Lawton, M. P. (1989). Depression among the institutionalised aged: assessment and prevalence estimation. Journal of Gerontology, 44, 2229.Google Scholar
Parmelee, P. A., Katz, I. R. and Lawton, M. P. (1992). Depression and mortality among institutionalized aged. Journal of Gerontology, 47, 310.Google Scholar
Payne, J. L. et al. (2002). Incidence, prevalence, and outcomes of depression in residents of a long-term care facility with dementia. International Journal of Geriatric Psychiatry, 17, 247253.Google Scholar
Phillips, C. J. and Henderson, A. S. (1991). The prevalence of depression among Australian nursing home residents: results using draft ICD-10 and DSM-IIIR criteria. Psychological Medicine, 21, 1618.CrossRefGoogle Scholar
Reifler, B. V. et al. (1989). Double-blind trial of imipramine in Alzheimer's disease patients with and without depression. American Journal of Psychiatry, 14, 4549.Google Scholar
Rovner, B. W., German, P. S., Brant, L. J., Clark, R., Burton, L. and Folstein, M. F. (1991). Depression and mortality in nursing homes. JAMA, 265, 993996.Google Scholar
Rozzini, R., Boffelli, S., Franzoni, S., Frisoni, G. B. and Trarucchi, M. (1996). Prevalence and predictors of depressive symptoms in a nursing home. International Journal of Geriatric Psychiatry, 11, 629634.Google Scholar
Snowdon, J., Burgess, E., Vaughan, R. and Miller, R. (1996). Use of antidepressants, and the prevalence of depression and cognitive impairment in Sydney nursing homes. International Journal of Geriatric Psychiatry, 11, 599606.Google Scholar
Snowdon, J. and Lane, F. (2001). The prevalence and outcome of depression and dementia in Botany's elderly population. International Journal of Geriatric Psychiatry, 16, 293299.Google Scholar
Streim, J. E. et al. (2000). Drug treatment of depression in frail elderly nursing home residents. American Journal of Geriatric Psychiatry, 8, 150159.Google Scholar
Teresi, J., Abrams, R., Holmes, D., Ramirez, M. and Eimicke, J. (2001). Prevalence of depression and depression recognition in nursing homes. Social Psychiatry and Psychiatric Epidemiology, 36, 613620.CrossRefGoogle ScholarPubMed
Teri, L., McKenzie, G. and LaFazia, D. (2005). Psychosocial treatment of depression in older adults with dementia. Clinical Psychology: Science and Practice, 12, 303316.Google Scholar
Trappler, B. and Cohen, C. I. (1998). Use of SSRIs in “very old” depressed nursing home residents. American Journal of Geriatric Psychiatry, 6, 8389.Google Scholar
Vida, S., Des Rosiers, P., Carrier, L. and Gauthier, S. (1994). Depression and Alzheimer's disease: receiver operating characteristic analysis of the Cornell Scale for Depression in Dementia and the Hamilton Depression Scale. Journal of Geriatric Psychiatry and Neurology, 7, 159162.Google Scholar