Depression and risk of hospitalization for pneumonia in a cohort study of older Americans

doi:10.1016/j.jpsychores.2014.08.002

. 2014 Dec;77(6):528-34.

doi: 10.1016/j.jpsychores.2014.08.002. Epub 2014 Aug 11.

Depression and risk of hospitalization for pneumonia in a cohort study of older Americans

Dimitry S Davydow¹, Catherine L Hough², Kara Zivin³, Kenneth M Langa⁴, Wayne J Katon⁵

Affiliations

¹ Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA. Electronic address: ddavydo1@u.washington.edu.
² Department Internal Medicine, University of Washington, Seattle, WA, USA.
³ Ann Arbor Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
⁴ Ann Arbor Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, USA; Institute for Social Research, University of Michigan, Ann Arbor, MI, USA; Department of Medicine, University of Michigan, Ann Arbor, MI, USA.
⁵ Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.

PMID: 25139125
PMCID: PMC4259844
DOI: 10.1016/j.jpsychores.2014.08.002

Depression and risk of hospitalization for pneumonia in a cohort study of older Americans

Dimitry S Davydow et al. J Psychosom Res. 2014 Dec.

. 2014 Dec;77(6):528-34.

doi: 10.1016/j.jpsychores.2014.08.002. Epub 2014 Aug 11.

Authors

Dimitry S Davydow¹, Catherine L Hough², Kara Zivin³, Kenneth M Langa⁴, Wayne J Katon⁵

Affiliations

¹ Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA. Electronic address: ddavydo1@u.washington.edu.
² Department Internal Medicine, University of Washington, Seattle, WA, USA.
³ Ann Arbor Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
⁴ Ann Arbor Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, USA; Institute for Social Research, University of Michigan, Ann Arbor, MI, USA; Department of Medicine, University of Michigan, Ann Arbor, MI, USA.
⁵ Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.

PMID: 25139125
PMCID: PMC4259844
DOI: 10.1016/j.jpsychores.2014.08.002

Abstract

Objective: The aim of this study is to determine if depression is independently associated with risk of hospitalization for pneumonia after adjusting for demographics, medical comorbidity, health-risk behaviors, baseline cognition and functional impairments.

Methods: This secondary analysis of prospectively collected data examined a population-based sample of 6704 Health and Retirement Study (HRS) (1998-2008) participants>50years old who consented to have their interviews linked to their Medicare claims and were without a dementia diagnosis. The eight-item Center for Epidemiologic Studies Depression Scale and/or International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) depression diagnoses were used to identify baseline depression. ICD-9-CM diagnoses were used to identify hospitalizations for which the principal discharge diagnosis was for bacterial or viral pneumonia. The odds of hospitalization for pneumonia for participants with depression relative to those without depression were estimated using logistic regression models. Population attributable fractions were calculated to determine the extent that hospitalizations for pneumonia could be attributable to depression.

Results: After adjusting for demographic characteristics, clinical factors, and health-risk behaviors, depression was independently associated with increased odds of hospitalization for pneumonia (odds ratio [OR]: 1.28, 95% confidence interval [95%CI]: 1.08, 1.53). This association persisted after adjusting for baseline cognition and functional impairments (OR: 1.24, 95%CI: 1.03, 1.50). In this cohort, 6% (95%CI: 2%, 10%) of hospitalizations for pneumonia were potentially attributable to depression.

Conclusion: Depression is independently associated with increased odds of hospitalization for pneumonia. This study provides additional rationale for integrating mental health care into medical settings in order to improve outcomes for older adults.

Keywords: Depression; Hospitalization; Outcome assessment (health care); Pneumonia.

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Conflict of interest statement

Disclosures of potential conflicts of interest: Dr. Katon has received honorariums for CME lectures from Eli Lilly, Forest, and Pfizer pharmaceutical companies. Drs. Davydow, Hough, Zivin and Langa have no relevant potential conflicts of interest to disclose.

CONFLICT OF INTEREST STATEMENT

All authors have completed the Unified Competing Interest form at http://www.icmje.org/coi_disclosure.pdf and declare that Dr. Katon has received honorariums for CME lectures from Eli Lilly, Forest, and Pfizer pharmaceutical companies. Drs. Davydow, Hough, Zivin and Langa have no relevant potential conflicts of interest to disclose.

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References

1. Thomas CP, Ryan M, Chapman JD, Stason WB, Tompkins CP, Suaya JA, et al. Incidence and cost of pneumonia in Medicare beneficiaries. Chest. 2012;142:973–981. - PubMed
1. Pfunter A, Wier LM, Stocks C. Most Frequent Conditions in U.S. Hospitals, 2010. Rockville, MD: Agency for Healthcare Research and Quality; Jan, 2013. HCUP Statistical Brief #148. - PubMed
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1. Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009;360:1418–1428. - PubMed

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[1] Thomas CP, Ryan M, Chapman JD, Stason WB, Tompkins CP, Suaya JA, et al. Incidence and cost of pneumonia in Medicare beneficiaries. Chest. 2012;142:973–981. - PubMed

[2] Thomas CP, Ryan M, Chapman JD, Stason WB, Tompkins CP, Suaya JA, et al. Incidence and cost of pneumonia in Medicare beneficiaries. Chest. 2012;142:973–981. - PubMed

[3] Pfunter A, Wier LM, Stocks C. Most Frequent Conditions in U.S. Hospitals, 2010. Rockville, MD: Agency for Healthcare Research and Quality; Jan, 2013. HCUP Statistical Brief #148. - PubMed

[4] Pfunter A, Wier LM, Stocks C. Most Frequent Conditions in U.S. Hospitals, 2010. Rockville, MD: Agency for Healthcare Research and Quality; Jan, 2013. HCUP Statistical Brief #148. - PubMed

[5] Kaplan V, Clermont G, Griffin MF, Kasal J, Watson RS, Linde-Zwirble WT, et al. Pneumonia: still the old man’s friend? Arch Intern Med. 2003;163:317–323. - PubMed

[6] Kaplan V, Clermont G, Griffin MF, Kasal J, Watson RS, Linde-Zwirble WT, et al. Pneumonia: still the old man’s friend? Arch Intern Med. 2003;163:317–323. - PubMed

[7] Davydow DS, Hough CL, Levine DA, Langa KM, Iwashyna TJ. Functional disability, cognitive impairment, and depression after hospitalization for pneumonia. Am J Med. 2013;126:615–624. - PMC - PubMed

[8] Davydow DS, Hough CL, Levine DA, Langa KM, Iwashyna TJ. Functional disability, cognitive impairment, and depression after hospitalization for pneumonia. Am J Med. 2013;126:615–624. - PMC - PubMed

[9] Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009;360:1418–1428. - PubMed

[10] Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009;360:1418–1428. - PubMed

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Depression and risk of hospitalization for pneumonia in a cohort study of older Americans

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Depression and risk of hospitalization for pneumonia in a cohort study of older Americans

Authors

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Conflict of interest statement

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