Trajectories of cognitive-affective depressive symptoms in acutely hospitalized older adults: The hospital-ADL study


<p><b>OBJECTIVE:</b> To 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.</p><p><b>METHODS:</b> Prospective 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.</p><p><b>RESULTS:</b> The 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 < .001; severe: OR = 3.0, p = .04), falls (mild: OR = 2.0, p = .02; severe: OR = 6.0, p < .001), and mortality (mild: OR = 2.2, p = .05; severe: OR = 3.4, p = .009). Patients with mild or severe persistent symptoms were more malnourished, anxious, and functionally limited and had more medical comorbidities at admission.</p><p><b>CONCLUSION:</b> Nearly 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.</p>

Reference Reichardt, L. A., van Seben, R., Aarden, J. J., van der Esch, M., van der Schaaf, M., Engelbert, R. H. H., Twisk, J. W. R., Bosch, J. A., & Buurman, B. M. (2019). Trajectories of cognitive-affective depressive symptoms in acutely hospitalized older adults: The hospital-ADL study. Journal of Psychosomatic Research, 120, 66-73.
Published by  Urban Vitality 1 May 2019

Publication date

May 2019


Lucienne A. Reichardt
Rosanne van Seben
Jos W.R. Twisk
Jos A. Bosch
Bianca M. Buurman


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