Depression in geriatric ED patients: prevalence and recognition

Ann Emerg Med. 1997 Aug;30(2):141-5. doi: 10.1016/s0196-0644(97)70132-x.


Study objective: To determine the prevalence of depression in geriatric ED patients and to assess recognition of geriatric depression by emergency physicians.

Methods: We conducted an observational survey of geriatric patients who presented to an urban, university-affiliated public hospital ED. A convenience sample of 259 patients aged 65 years or older were administered a brief, self-rated depression scale. Main outcome measures were prevalence of depression (using a predetermined cutoff score for detecting depression) and recognition of depression by the treating emergency physician, assessed by chart review.

Results: Seventy subjects (27%; 95% confidence interval [CI], 22% to 32%) were rated as depressed. Depressed and nondepressed patients were not significantly different with regard to age, sex, race, or education. Forty-seven percent of nursing home residents were depressed, compared with 24% of those living independently (95% CI for difference of 23%, 6% to 41%). Patients who described their health as poor were also more likely to be depressed (33 of 65, 51%) than patients who reported their health to be good or fair (37 of 194, 19%) (95% CI for difference of 32%, 18% to 45%). Emergency physicians failed to recognize depression in all the patients found to be depressed on this scale (95% CI, 0 to 5%).

Conclusion: The prevalence of unrecognized depression in the geriatric ED patients we studied was high, especially in those who reported their health as poor. Use of a brief depression scale can aid recognition of depression in older patients, leading to appropriate referral and treatment.

MeSH terms

  • Aged
  • Depression / diagnosis*
  • Diagnosis, Differential
  • Emergency Service, Hospital
  • Female
  • Geriatrics*
  • Health Status
  • Humans
  • Male
  • Prevalence
  • Psychological Tests
  • Sensitivity and Specificity