Skip to main content
NCBI home page
CMAJ : Canadian Medical Association Journal logoLink to CMAJ : Canadian Medical Association Journal
. 1997 Oct 15;157(8):1055–1060.

Depression in elderly medical inpatients: a meta-analysis of outcomes

M G Cole 1, F Bellavance 1
PMCID: PMC1228261  PMID: 9347776

Abstract

OBJECTIVE: To determine the prognosis of elderly medical inpatients with depression. DATA SOURCES: A MEDLINE search for relevant articles published from January 1980 to September 1996 and a search of the PSYCH INFO database for articles published from January 1984 to September 1996. The bibliographies of identified articles were searched for additional references. STUDY SELECTION: Eight reports (involving 265 patients with depression) met the following 5 inclusion criteria: original research, published in English or French, population of general medical inpatients, mean age of depressed patients 60 years and over, and affective state reported as an outcome. The validity of the studies was assessed according to the criteria for prognostic studies described by the Evidence-Based Medicine Working Group. DATA EXTRACTION: Information about the patient population, the proportion of cases detected and treated by attending physicians, the length of follow-up, the affective outcome and the prognostic factors was abstracted from each report. DATA SYNTHESIS: All of the studies had some methodologic limitations. A meta-analysis of outcomes at 3 months or less indicated that 18% of patients were well, 43% were depressed and 22% were dead. At 12 months or more, 19% were well, 29% were depressed and 53% were dead. Factors associated with worse outcomes included more severe depression, more serious physical illness and symptoms of depression before admission. CONCLUSIONS: Elderly medical inpatients who are depressed appear to have a very poor prognosis: the recovery rate among these patients is low and the mortality rate high.

Full Text

The Full Text of this article is available as a PDF (106.3 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blazer D. Depression in the elderly. N Engl J Med. 1989 Jan 19;320(3):164–166. doi: 10.1056/NEJM198901193200306. [DOI] [PubMed] [Google Scholar]
  2. Cole M. G., Bellavance F. The prognosis of depression in old age. Am J Geriatr Psychiatry. 1997 Winter;5(1):4–14. [PubMed] [Google Scholar]
  3. Copeland J. R., Dewey M. E., Griffiths-Jones H. M. A computerized psychiatric diagnostic system and case nomenclature for elderly subjects: GMS and AGECAT. Psychol Med. 1986 Feb;16(1):89–99. doi: 10.1017/s0033291700057779. [DOI] [PubMed] [Google Scholar]
  4. DerSimonian R., Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986 Sep;7(3):177–188. doi: 10.1016/0197-2456(86)90046-2. [DOI] [PubMed] [Google Scholar]
  5. Dunham N. C., Sager M. A. Functional status, symptoms of depression, and the outcomes of hospitalization in community-dwelling elderly patients. Arch Fam Med. 1994 Aug;3(8):676–681. doi: 10.1001/archfami.3.8.676. [DOI] [PubMed] [Google Scholar]
  6. Feighner J. P., Robins E., Guze S. B., Woodruff R. A., Jr, Winokur G., Munoz R. Diagnostic criteria for use in psychiatric research. Arch Gen Psychiatry. 1972 Jan;26(1):57–63. doi: 10.1001/archpsyc.1972.01750190059011. [DOI] [PubMed] [Google Scholar]
  7. Fenton F. R., Cole M. G., Engelsmann F., Mansouri I. Depression in older medical inpatients: one-year course and outcome. Int J Geriatr Psychiatry. 1997 Mar;12(3):389–394. [PubMed] [Google Scholar]
  8. Ganzini L., Smith D. M., Fenn D. S., Lee M. A. Depression and mortality in medically ill older adults. J Am Geriatr Soc. 1997 Mar;45(3):307–312. doi: 10.1111/j.1532-5415.1997.tb00945.x. [DOI] [PubMed] [Google Scholar]
  9. Incalzi R. A., Gemma A., Capparella O., Muzzolon R., Antico L., Carbonin P. U. Effects of hospitalization on affective status of elderly patients. Int Psychogeriatr. 1991 Spring;3(1):67–74. doi: 10.1017/s1041610291000534. [DOI] [PubMed] [Google Scholar]
  10. Koenig H. G., Shelp F., Goli V., Cohen H. J., Blazer D. G. Survival and health care utilization in elderly medical inpatients with major depression. J Am Geriatr Soc. 1989 Jul;37(7):599–606. doi: 10.1111/j.1532-5415.1989.tb01249.x. [DOI] [PubMed] [Google Scholar]
  11. Laupacis A., Wells G., Richardson W. S., Tugwell P. Users' guides to the medical literature. V. How to use an article about prognosis. Evidence-Based Medicine Working Group. JAMA. 1994 Jul 20;272(3):234–237. doi: 10.1001/jama.272.3.234. [DOI] [PubMed] [Google Scholar]
  12. Oxman A. D., Cook D. J., Guyatt G. H. Users' guides to the medical literature. VI. How to use an overview. Evidence-Based Medicine Working Group. JAMA. 1994 Nov 2;272(17):1367–1371. doi: 10.1001/jama.272.17.1367. [DOI] [PubMed] [Google Scholar]
  13. Pomerantz A. S., de Nesnera A., West A. N. Resolution of depressive symptoms in medical inpatients after discharge. Int J Psychiatry Med. 1992;22(3):281–289. doi: 10.2190/FL6W-7QWW-7KQJ-KRX8. [DOI] [PubMed] [Google Scholar]
  14. Rapp S. R., Parisi S. A., Wallace C. E. Comorbid psychiatric disorders in elderly medical patients: a 1-year prospective study. J Am Geriatr Soc. 1991 Feb;39(2):124–131. doi: 10.1111/j.1532-5415.1991.tb01613.x. [DOI] [PubMed] [Google Scholar]
  15. Schuckit M. A., Miller P. L., Berman J. The three year course of psychiatric problems in a geriatric population. J Clin Psychiatry. 1980 Jan;41(1):27–32. [PubMed] [Google Scholar]
  16. Yesavage J. A., Brink T. L., Rose T. L., Lum O., Huang V., Adey M., Leirer V. O. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982;17(1):37–49. doi: 10.1016/0022-3956(82)90033-4. [DOI] [PubMed] [Google Scholar]

Articles from CMAJ: Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES