Depression and increased risk of mortality in the nursing home patient.

Depression is a common clinical syndrome in the elderly, often resulting in attempted and/or successful suicide. Within the community and in a wide range of medical care settings, including nursing homes, depression is often undiagnosed and untreated. In a 1-year investigation that included 454 new patient admissions to eight Baltimore area nursing home facilities, major depressive disorder occurred in 12.6% of patients; an additional 18.1% had depressive symptoms. Most cases of depression were unrecognized and therefore untreated by nursing home physicians. Major depressive disorder was found to be an independent risk factor for mortality that increased the likelihood of death by 59% in the first year after diagnosis. Because new federal regulations now mandate the assessment of depression in nursing home patients, improved diagnosis and therapy (and therefore reduced disability and mortality) may be expected in the future.