1. Trajectories of cognitive-affective depressive symptoms in acutely hospitalized older adults
- Author
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Jesse J. Aarden, Martin van der Esch, Jos W. R. Twisk, Rosanne van Seben, Bianca M. Buurman, Jos A. Bosch, Marike van der Schaaf, Lucienne A Reichardt, Raoul H.H. Engelbert, APH - Quality of Care, APH - Aging & Later Life, AMS - Ageing & Morbidty, Graduate School, ANS - Neuroinfection & -inflammation, AMS - Restoration & Development, Rehabilitation medicine, Medical Psychology, Geriatrics, Nursing, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, APH - Mental Health, APH - Digital Health, Klinische Psychologie (Psychologie, FMG), Kenniscentrum ACHIEVE, Urban Vitality, Lectoraat Interdisciplinaire Zorg voor Chronische Gewrichtsaandoeningen, APH - Methodology, APH - Health Behaviors & Chronic Diseases, Epidemiology and Data Science, and ACS - Atherosclerosis & ischemic syndromes
- Subjects
Male ,Group based ,Pediatrics ,medicine.medical_specialty ,Comorbidity ,Cohort Studies ,03 medical and health sciences ,Cognition ,0302 clinical medicine ,Older patients ,Acute care ,Activities of Daily Living ,Humans ,Medicine ,Prospective Studies ,030212 general & internal medicine ,Depressive symptoms ,Screening procedures ,Depression (differential diagnoses) ,Aged ,Aged, 80 and over ,Depression ,business.industry ,Patient Discharge ,Hospitalization ,Affect ,Psychiatry and Mental health ,Clinical Psychology ,Cohort ,Female ,business ,030217 neurology & neurosurgery - Abstract
ObjectiveTo identify trajectories of cognitive-affective depressive symptoms among acutely hospitalized older patients and whether trajectories are related to prognostic baseline factors and three-month outcomes such as functional decline, falls, unplanned readmissions, and mortality.MethodsProspective multicenter cohort of acutely hospitalized patients aged ≥ 70. Depressive trajectories were based on Group Based Trajectory Modeling, using the Geriatric Depression Scale-15. Outcomes were functional decline, falls, unplanned readmission, and mortality within three months post-discharge.ResultsThe analytic sample included 398 patients (mean age = 79.6 years; SD = 6.6). Three distinct depressive symptoms trajectories were identified: minimal (63.6%), mild persistent (25.4%), and severe persistent (11.0%). Unadjusted results showed that, compared to the minimal symptoms group, the mild and severe persistent groups showed a significantly higher risk of functional decline (mild: OR = 3.9, p ConclusionNearly 40% of the acutely hospitalized older adults exhibited mild to severe levels of cognitive-affective depressive symptoms. In light of the substantially elevated risk of serious complications and the fact that elevated depressive symptoms was not a transient phenomenon identification of these patients is needed. This further emphasizes the need for acute care hospitals, as a point of engagement with older adults, to develop discharge or screening procedures for managing cognitive-affective depressive symptoms.
- Published
- 2019