The course of depression and the economic consequences in the 6-month period after hospitalization for congestive heart failure were examined in a prospective observational cohort study involving 203 older adults (mean age=76.8 years, SD=7.8). At discharge, 73 of 203 subjects (36%) were depressed according to the screening criteria of the Geriatric Depression Scale, and 44 (22%) were depressed according to the Structured Clinical Interview for DSM-III-R-Non-Patient Edition. The proportions were 33% and 20% of 166 subjects, respectively, at 4 weeks and 26% and 17% of 113 subjects, respectively, at 24 weeks. Depressed patients used more medical resources after discharge than nondepressed patients. Additional research is required to determine whether the optimal time to identify and treat depressed older adults with congestive heart failure is during a hospital stay or after discharge.