Does depression predict adverse outcomes for older medical inpatients? A prospective cohort study of individuals screened for a trial*

Objective: To examine the relationship between depressive symptoms and hospital outcomes in an unselected consecutive sample of older medical inpatients. Design: A prospective cohort study of individuals screened for a trial. Setting: Medical wards of UK district general hospital in rural East Anglia. Participants: Six hundred and seventeen medical inpatients aged 65+ were randomly selected from consecutive admissions. Baseline measures: 15-item Geriatric Depression Scale (GDS-15), the Abbreviated Mental Test Score (AMTS) and the Cumulative Illness Rating Scale-Geriatric (CIRS-G). Main outcome measures: Length of hospital stay; discharge to a community hospital (for rehabilitation), institutional care or usual place of residence; dying in hospital. Results: Depressive symptoms are independently associated with an increased likelihood of inpatient death and transfer to a community hospital for rehabilitation, but are not associated with longer length of stay. Conclusions: Research evaluating effectiveness of identification and treatment of depression in older medical inpatients should consider including inpatient death and use of rehabilitation services as potential outcomes. © The Author 2008. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.