A 12 months follow-up study of depression among nursing-home patients in Norway

Abstract

Background: Depression is common in nursing-home patients and is often of chronic nature.

Aims: To examine the prevalence, incidence and the persistence rates of clinically significant depressive symptoms, and their risk factors among nursing-home patients.

Design: A 12 months follow-up study.

Methods: A sample of 902 randomly selected nursing-home patients was assessed using the Cornell Scale, the Clinical Dementia Rating Scale, the Self-Maintenance Scale and a measurement of physical health. Information was collected from the patients' records. Clinically significant depression was defined as 8+ on the Cornell Scale.

Results: At 12 months 231 had died, and depression was together with higher age, worse physical health, poor function in activities of daily living, higher CDR score and cancer a significant predictor of death (0.03). The prevalence of depression was 21.2% at baseline and follow-up, incidence rate was 14.9% and persistence rate was 44.8%. Predictors of depression at 12 months were: high Cornell score at baseline (p<0.001), a shorter stay in a nursing home (0.011) and use of antidepressants (p=0.050); for incident depression: higher Cornell score at baseline (p=0.019), a shorter stay (p=0.002) and higher CDR score (p=0.003); for persistent depression: higher Cornell score at baseline (0.011), use of anxiolytics (p=0.045) and not being married (p=0.037).

Conclusion: The incidence and persistence rates of clinical significant depressive symptoms are high in nursing-home patients. A higher score on Cornell Scale at baseline and a shorter stay in a nursing home were predictors for both incidence and persistence of clinically significant depressive symptoms.