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  • Title: Depressed mood, cognitive impairment, and survival in older people admitted to care homes in England.
    Author: Sutcliffe C, Burns A, Challis D, Mozley CG, Cordingley L, Bagley H, Huxley P.
    Journal: Am J Geriatr Psychiatry; 2007 Aug; 15(8):708-15. PubMed ID: 17504909.
    Abstract:
    OBJECTIVE: To investigate psychiatric morbidity, cognitive impairment, dependency, and survival in residents newly admitted to care homes. METHODS: A total of 308 older people were assessed using measures of cognitive impairment and depressive symptomatology, and interviewable residents completed a quality-of-life interview. Dependency levels were assessed by interviews with staff and medication data were collected from home records. Follow-up assessments were carried out at five and nine months. A telephone follow-up approximately 12 months later augmented the survival data. RESULTS: Of residents whose outcomes were known, 73% survived throughout the nine-month study period. Residents who died before the five-month follow-up had higher scores on the depression measure than those surviving longer. Reduced survival was predicted by greater dependency at baseline. Of 188 surviving residents, 63 (38%) were classified as depressed at baseline. Twenty-seven (43%) of the latter were still classed as depressed at five and nine months. Just 19% of residents rated as depressed at baseline were prescribed antidepressant medication, increasing to 26% at each follow-up. There was significant coexistence of cognitive impairment and depressive symptomatology. CONCLUSION: High levels of mortality, psychiatric morbidity, and chronicity of depressed mood among residents requires care homes to improve access to specialist resources such as geriatric consultation, old-age psychiatry, occupational therapy, and physiotherapy. Findings suggest that future care standards should include external factors, such as the extent of access to relevant specialist services for vulnerable older people.
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