Depressive symptoms in elderly patients predict poor adjustment after somatic events

Am J Geriatr Psychiatry. Jan-Feb 2004;12(1):57-64.

Abstract

Objective: The authors tested the hypothesis that elderly subjects with premorbid depressive symptoms are at increased risk of poor adjustment after a somatic event.

Methods: The GLAS study contains a baseline assessment and a follow-up of subjects who experienced post-baseline acute myocardial infarction, cancer, congestive heart failure, or fall-related injury of the extremities within 5 years after baseline assessment. Follow-up was conducted at 8 weeks, 6 months, and 1 year after the somatic event. Of a baseline sample of 5,279 elderly subjects (57 and older), 1,124 subjects who experienced one of the specified events were contacted, and sufficient follow-up data were obtained from 558 subjects. Authors analyzed the course of self-reported physical, role, and social functioning, and general health and well-being in subjects without baseline limitations. Patients with poor adjustment after the event were compared with patients with good adjustment on baseline depressive symptoms. They used logistic-regression analysis, controlling for several confounders.

Results: In multivariate analyses, pre-event depressive symptoms were associated with an increased risk of poor adjustment in terms of social and role functioning, well-being, and general health, but not physical functioning.

Conclusions: Elderly persons living in the community reporting depressive symptoms are at increased risk of poor psychosocial adjustment after a somatic event. Each reported baseline depressive symptom was associated with an increased risk of chronic decline; this finding stresses the importance of detecting and treating depression in community-living elderly persons.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adjustment Disorders / epidemiology*
  • Adjustment Disorders / etiology*
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Depression / psychology*
  • Disability Evaluation
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Population Surveillance
  • Prospective Studies
  • Risk Factors
  • Somatoform Disorders / psychology*