Cognitive Impairment and Depression Predict Mortality in Medically Ill Older Adults

Background. Depression and cognitive impairment are common in medically ill older adults. Few studies, however, have investigated the roles of both in predicting mortality for medically ill older adults. Methods. We used a cohort of consecutive patients aged 60 or older admitted to a rehabilitation...

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Bibliographic Details
Published in:The journals of gerontology. Series A, Biological sciences and medical sciences Biological sciences and medical sciences, 1999-03, Vol.54 (3), p.M152-M156
Main Authors: Arfken, Cynthia L., Lichtenberg, Peter A., Tancer, Manuel E.
Format: Article
Language:English
Subjects:
Activities of Daily Living
Age Factors
Aged
Cognition & reasoning
Cognition Disorders - epidemiology
Cohort Studies
Dementia - epidemiology
Depression - epidemiology
Disabled Persons
Disease
Female
Follow-Up Studies
Forecasting
Humans
Male
Medical disorders
Mental depression
Michigan - epidemiology
Middle Aged
Mortality
Multivariate Analysis
Odds Ratio
Older people
Risk Factors
Sex Factors
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Summary:Background. Depression and cognitive impairment are common in medically ill older adults. Few studies, however, have investigated the roles of both in predicting mortality for medically ill older adults. Methods. We used a cohort of consecutive patients aged 60 or older admitted to a rehabilitation hospital (N = 667) of whom 455 completed a standardized protocol measuring cognition (Dementia Rating Scale), depression (Geriatric Depression Scale), and disabilities (Functional Independence Measure). Burden of medical illnesses was measured with the Charlson Index. Vital status was assessed one year later. Results. Those subjects who did not complete the screening were more likely to die (24% vs 17%; p = .02) during the oneyear follow-up. Of those who completed the screening, male sex (odds ratio [OR] = 1.84), depression (mild OR = 1.64; moderate OR = 2.49), and more severe cognitive impairment (OR = 2.13) predicted mortality independent of age, medical illnesses, or disabilities. No interaction of cognitive impairment and depression was detected. In those subjects cognitively intact, moderate depression (OR = 4.95) and male sex (OR = 3.42) were independent risk factors for dying. In those subjects without depression, male sex (OR = 2.24) and elevated Charlson Index (OR = 1.42) predicted mortality. Conclusions. Depression and cognitive impairment are independent predictors of one-year mortality in this subgroup of medically ill older adults.
ISSN:1079-5006
1758-535X
DOI:10.1093/gerona/54.3.M152