Depressive Symptoms in Elderly Patients Predict Poor Adjustment After Somatic Events

• Published in: The American journal of geriatric psychiatry 2004-01, Vol.12 (1), p.57-64
• Main Authors: de Jonge, Peter, Ormel, Johan, Slaets, Joris P.J., Kempen, Gertrudis I.J.M., Ranchor, Adelita V., van Jaarsveld, Cornelia H.M., Scaf-Klomp, Winnie, Sanderman, Robbert
• Format: Article
• Language: English
• Subjects: Adjustment Disorders - epidemiology; Adjustment Disorders - etiology; Aged; Aged, 80 and over; Cohort Studies; Depression - psychology; Disability Evaluation; Female; Follow-Up Studies; Humans; Male; Middle Aged; Population Surveillance; Prospective Studies; Risk Factors; Somatoform Disorders - psychology
• ISSN: 1064-7481; 1545-7214
• DOI: 10.1097/00019442-200401000-00008

The authors tested the hypothesis that elderly subjects with premorbid depressive symptoms are at increased risk of poor adjustment after a somatic event. The GLAS study contains a baseline assessment and a follow-up of subjects who experienced post-baseline acute myocardial infarction, cancer, congestive heart failure, or fall-related injury of the extremities within 5 years after baseline assessment. Follow-up was conducted at 8 weeks, 6 months, and 1 year after the somatic event. Of a baseline sample of 5,279 elderly subjects (57 and older), 1,124 subjects who experienced one of the specified events were contacted, and sufficient follow-up data were obtained from 558 subjects. Authors analyzed the course of self-reported physical, role, and social functioning, and general health and well-being in subjects without baseline limitations. Patients with poor adjustment after the event were compared with patients with good adjustment on baseline depressive symptoms. They used logistic-regression analysis, controlling for several confounders. In multivariate analyses, pre-event depressive symptoms were associated with an increased risk of poor adjustment in terms of social and role functioning, well-being, and general health, but not physical functioning. Elderly persons living in the community reporting depressive symptoms are at increased risk of poor psychosocial adjustment after a somatic event. Each reported baseline depressive symptom was associated with an increased risk of chronic decline; this finding stresses the importance of detecting and treating depression in community-living elderly persons.