STUDY OBJECTIVE: To determine the prevalence of depression in geriatric ED patients and to assess recognition of geriatric depression by emergency physicians. METHODS: We conducted an observational survey of geriatric patients who presented to an urban, university-affiliated public hospital ED. A convenience sample of 259 patients aged 65 years or older were administered a brief, self-rated depression scale. Main outcome measures were prevalence of depression (using a predetermined cutoff score for detecting depression) and recognition of depression by the treating emergency physician, assessed by chart review. RESULTS: Seventy subjects (27%; 95% confidence interval [CI], 22% to 32%) were rated as depressed. Depressed and nondepressed patients were not significantly different with regard to age, sex, race, or education. Forty-seven percent of nursing home residents were depressed, compared with 24% of those living independently (95% CI for difference of 23%, 6% to 41%). Patients who described their health as poor were also more likely to be depressed (33 of 65, 51%) than patients who reported their health to be good or fair (37 of 194, 19%) (95% CI for difference of 32%, 18% to 45%). Emergency physicians failed to recognize depression in all the patients found to be depressed on this scale (95% CI, 0 to 5%). CONCLUSION: The prevalence of unrecognized depression in the geriatric ED patients we studied was high, especially in those who reported their health as poor. Use of a brief depression scale can aid recognition of depression in older patients, leading to appropriate referral and treatment.
STUDY OBJECTIVE: To determine the prevalence of depression in geriatric ED patients and to assess recognition of geriatric depression by emergency physicians. METHODS: We conducted an observational survey of geriatric patients who presented to an urban, university-affiliated public hospital ED. A convenience sample of 259 patients aged 65 years or older were administered a brief, self-rated depression scale. Main outcome measures were prevalence of depression (using a predetermined cutoff score for detecting depression) and recognition of depression by the treating emergency physician, assessed by chart review. RESULTS: Seventy subjects (27%; 95% confidence interval [CI], 22% to 32%) were rated as depressed. Depressed and nondepressed patients were not significantly different with regard to age, sex, race, or education. Forty-seven percent of nursing home residents were depressed, compared with 24% of those living independently (95% CI for difference of 23%, 6% to 41%). Patients who described their health as poor were also more likely to be depressed (33 of 65, 51%) than patients who reported their health to be good or fair (37 of 194, 19%) (95% CI for difference of 32%, 18% to 45%). Emergency physicians failed to recognize depression in all the patients found to be depressed on this scale (95% CI, 0 to 5%). CONCLUSION: The prevalence of unrecognized depression in the geriatric ED patients we studied was high, especially in those who reported their health as poor. Use of a brief depression scale can aid recognition of depression in older patients, leading to appropriate referral and treatment.
Authors: Christopher R Carpenter; Kennon Heard; Scott Wilber; Adit A Ginde; Kirk Stiffler; Lowell W Gerson; Neal S Wenger; Douglas K Miller Journal: Acad Emerg Med Date: 2011-06 Impact factor: 3.451
Authors: Brenda M Booth; Maureen A Walton; Kristin L Barry; Rebecca M Cunningham; Stephen T Chermack; Frederic C Blow Journal: J Behav Health Serv Res Date: 2011-07 Impact factor: 1.505
Authors: Monica Cepoiu; Jane McCusker; Martin G Cole; Maida Sewitch; Eric Belzile; Antonio Ciampi Journal: J Gen Intern Med Date: 2007-10-26 Impact factor: 5.128