Depressive symptoms among frail elderly in ordinary living: who is affected and who is treated?

Abstract

Objectives: Depression is common but not always recognized and often undertreated among elderly. Cardiovascular diagnoses have been reported to be associated with depression. The study examined if this association could be confirmed in a frail elderly population. It also assessed the association between high depressive scores and certain health complaints and the use of certain drugs, respectively.

Method: A total of 153 frail elderly in ordinary living were included. The association between depressive symptoms, assessed by geriatric depression scale (GDS) 20, and an inpatient diagnose of cerebrovascular disease or heart failure was assessed. Depressive symptoms were also compared with health complaints and background data. Furthermore, the use of certain drugs, such as antidepressants and other psychotropics, was compared with depressive symptoms.

Results: Risk of depression was seen in 52% of the patients. Those showing risk of depression more often received municipal care or help with medication distribution and were more often treated with sedatives. They also had significantly more health complaints. No differences were found between those who had or did not have a diagnosis of heart failure or transient ischemic attack (TIA)/stroke during hospital care the previous year regarding risk for depression or treatment with antidepressants, respectively. Sixteen per cent were treated with antidepressants and this group was significantly younger than those who were not treated.

Conclusion: Those elderly with a GDS score indicating a risk for depression have poorer health, are more dependent on help and are more often treated with sedatives. The study could not confirm an association between heart failure or TIA/stroke and risk for depression.

Keywords:

• elderly
• depression
• GDS 20
• antidepressive treatment
• cardiovascular disease

Acknowledgements

This project was carried out as a collaboration between the Faculty of Medicine at Lund University, the Vårdal Institute, Lund University Hospital, and the primary care and the municipality of Eslöv. We are grateful to the Faculty of Medicine at Lund University, the Greta and Johan Kock Foundation, the Vårdal Institute, the Governmental Funding of Clinical Research within the NHS (ALF) and the Swedish Research Council for funding this study.