Abstract
Objective
To evaluate the effect of depression on functional recovery in geriatric patients
who have completed an inpatient rehabilitation program.
Design
Prospective cohort study.
Setting
Inpatient rehabilitation unit of a university-affiliated geriatric hospital.
Participants
Convenience sample of patients (N=65; mean age, 81.6y; 25 men) admitted to rehabilitation
over a 10-month period. Patients >60 years of age who were proficient in English and
capable of providing informed consent were eligible to participate in the study.
Interventions
Depression was assessed using both the Geriatric Depression Scale-short form (GDS-15)
and the Patient Health Questionnaire (9-item screen for depression) (PHQ-9). Measures
of well-established predictors of rehabilitation outcome, which may interact with
depression, were also obtained, and multiple regression linear modeling was used to
evaluate the relation between depression and functional outcome over and above the
contribution of these other factors.
Main Outcome Measure
FIM (Functional Independence Measure) at discharge from the rehabilitation program.
Results
Depression, as assessed by the GDS-15, but not the PHQ-9, was predictive of functional
outcome (standardized beta=−.151, P=.030) after controlling for other significant predictors, which included baseline
disability, pain, cognition, and educational level. Participation in recreational,
but not physio- or occupational, therapy additionally contributed to a small amount
of variance in the functional outcome.
Conclusions
Our findings suggest that self-report of depression is an independent predictor of
functional outcome in high-tolerance, short-duration geriatric rehabilitation. Routine
assessment of depressive symptoms in older adults using an instrument (eg, GDS-15)
may help identify those at risk for poorer outcomes in rehabilitation.
Keywords
List of abbreviations:
GDS-15 (Geriatric Depression Scale-short form), MoCA (Montreal Cognitive Assessment), OT (occupational therapy), PHQ-9 (Patient Health Questionnaire (9-item screen for depression)), PT (physiotherapy), RT (recreational therapy)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 13, 2016
Footnotes
Supported by the Academic Health Science Centers Academic Funding Plan Innovation Fund, Ontario Ministry of Health and Long-Term Care, and Baycrest Department of Psychiatry.
The funding parties had no involvement in the design of the study, the collection and analysis of the data, or the writing of the manuscript.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine