RESUMO
OBJECTIVES: To examine the prevalence and associated risk factors of depression in older patients discharged home from acute medical care and their influence on duration of survival in the community. DESIGN: A cross-sectional, prevalence study of depression in recently discharged patients and a prospective, case-controlled study of depressed and psychiatrically asymptomatic sub groups, exploring the relationship between depression, associated risk factors, and duration of survival in the community. SETTING: A community study of patients aged 75 and older discharged from the Countess of Chester Hospital and Wirral Hospitals Trust serving Wirral and West Cheshire, England. PARTICIPANTS: Three hundred and eleven patients were entered into the prevalence study. One hundred and fifty-eight patients (54 depressed and 104 asymptomatic) were entered into the prospective case controlled study and followed up for up to two years. MEASUREMENTS: Depression was defined by GMS/AGECAT criteria. Demographic details, handicap, pain, forced expiratory volume and social network were measured as dependent variables in the prevalence study and included in the analysis of risk factors potentially associated with duration of survival in the community. RESULTS: A depression prevalence rate of 17.4% was found. Age (p = 0.049, CI; 0.813, 0.999), forced expiratory volume (p = 0.034, CI; 0.991, 1.000) and handicap (p = 0.000, CI; 1.268, 1.723) were associated with depression but depression (p = 0.040, CI; 1.039, 4.915) was the only base-line variable associated with reduced survival in the community as defined by mortality and re-admission. CONCLUSIONS: Depression is common in older people discharged from acute medical care and is a major risk factor for reduced duration of community survival.
