Andreas Hoell1, Siegfried Weyerer2, Wolfgang Maier3, Michael Wagner3, Martin Scherer4, Anne Stark4, Hanna Kaduszkiewicz5, Birgitt Wiese6, Hans-Helmut König7, Jens-Oliver Bock7, Janine Stein8, Steffi G Riedel-Heller8. 1. Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany. Electronic address: Andreas.Hoell@zi-mannheim.de. 2. Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany. 3. Department of Psychiatry, University of Bonn and German Center for Neurodegenerative Diseases within the Helmholtz Association, Bonn, Germany. 4. Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 5. Institute of General Practice, Medical Faculty, Kiel University, Kiel, Germany. 6. Institute for General Practice, Working Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany. 7. Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Centre Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany. 8. Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany.
Abstract
BACKGROUND: Depression is the most common psychiatric disease in older people, often accompanied by co-morbidities and functional limitations. In cross-sectional studies, depression is associated with an increased use of health care resources, including informal care and home care. Longitudinal data are needed to better understand the causal links between depression, functional impairments, and health care utilization. METHODS: Data were obtained at baseline and follow-up of the multicenter, prospective cohort study "Late life depression in primary care: needs, health care utilization and costs" (AgeMooDe). A sample of 955 primary care patients aged 75 years and older was interviewed twice. The primary outcomes were the average respective amounts of time spent utilizing home care, professional nursing care, domestic help and informal care. These outcomes were analyzed with Generalized Linear Mixed Models (GLMM). RESULTS: GLMM analysis revealed that the amount of time utilizing home care over the study period was positively associated with depression, higher age, and functional and cognitive impairments, but negatively associated with living alone. In-depth analyses revealed that these associations were particularly obvious for the utilization of informal care. LIMITATIONS: The generalizability of our findings may be limited due to use of a dimensional instrument to determine depressive symptoms. CONCLUSIONS: Over the study period, the average amount of time receiving home care and especially informal care increased in the group of patients with depression only. People with depressive symptoms experience a growing number of functional limitations over time, increasing their dependency on others. Functional limitations, depression and dependency appear to form a vicious cycle.
BACKGROUND:Depression is the most common psychiatric disease in older people, often accompanied by co-morbidities and functional limitations. In cross-sectional studies, depression is associated with an increased use of health care resources, including informal care and home care. Longitudinal data are needed to better understand the causal links between depression, functional impairments, and health care utilization. METHODS: Data were obtained at baseline and follow-up of the multicenter, prospective cohort study "Late life depression in primary care: needs, health care utilization and costs" (AgeMooDe). A sample of 955 primary care patients aged 75 years and older was interviewed twice. The primary outcomes were the average respective amounts of time spent utilizing home care, professional nursing care, domestic help and informal care. These outcomes were analyzed with Generalized Linear Mixed Models (GLMM). RESULTS: GLMM analysis revealed that the amount of time utilizing home care over the study period was positively associated with depression, higher age, and functional and cognitive impairments, but negatively associated with living alone. In-depth analyses revealed that these associations were particularly obvious for the utilization of informal care. LIMITATIONS: The generalizability of our findings may be limited due to use of a dimensional instrument to determine depressive symptoms. CONCLUSIONS: Over the study period, the average amount of time receiving home care and especially informal care increased in the group of patients with depression only. People with depressive symptoms experience a growing number of functional limitations over time, increasing their dependency on others. Functional limitations, depression and dependency appear to form a vicious cycle.
Authors: Elżbieta W Buczak-Stec; Margrit Löbner; Janine Stein; Anne Stark; Hanna Kaduszkiewicz; Jochen Werle; Kathrin Heser; Birgitt Wiese; Siegfried Weyerer; Michael Wagner; Martin Scherer; Steffi G Riedel-Heller; Hans-Helmut König; André Hajek Journal: Front Med (Lausanne) Date: 2022-07-22
Authors: Anne O E van den Bulck; Arianne M J Elissen; Silke F Metzelthin; Maud H de Korte; Gertjan S Verhoeven; Teuntje A T de Witte-Breure; Lieuwe C van der Weij; Misja C Mikkers; Dirk Ruwaard Journal: BMC Health Serv Res Date: 2022-03-25 Impact factor: 2.655