Researchers explore the link between depression and nursing home admissions among adults aged 65 and older.
Depression and aging do not necessarily go hand in hand. A survey of Californians age 50-95 found that factors such as chronic illness, physical disabilities, and social isolation -- which often coincide with increasing age -- were stronger predictors of depression than age itself. That said, the incidence of depression is clearly higher in older adults. The National Institute of Mental Health’s Epidemiologic Catchment Area Study, which focuses on several major geographical areas, estimated that at least one million of the nation’s 31 million people age 65 and older suffer from major depression, and an additional five million have symptoms of depression that are severe enough to require treatment. Unfortunately, the depression is often undiagnosed, misdiagnosed, or left untreated in the elderly. There is also reason to believe that late-life depression can be more serious than depression in younger people.
Now a study in the Journal of the American Geriatrics Society (Volume 54, page 593) reports that older people who frequently feel sad or depressed are at greater risk for needing to be admitted to a nursing home than older people who feel well – this according to a review of data from Medicare beneficiaries age 65 and older. They are also at increased risk for subsequent death.
Of the 137,632 people for whom data were available, 11,220 were admitted to a nursing home within 2.5 years. Of the total group, 13,621 subjects said they had experienced symptoms of depression much of the time over the past year; of these, 2,005 (13.1%) entered a nursing home within the 3.5-year study period.
Other factors associated with nursing home admission were poor health (such as heart failure, diabetes, cancer, history of stroke, heart attack, and arthritis), limited physical functioning, increasing age, and low income. Men and women were equally likely to need nursing home care, although after adjustment for health and other factors, men had a higher risk than women. The researchers suggested that symptoms of depression may exacerbate existing medical illnesses or be caused by medical illnesses, both of which can increase the risk of frailty and the need for institutionalized care. Depression may also lead to poor health habits, such as inadequate nutrition and increased alcohol use.
