A large study of newly admitted nursing home residents has pinpointed the factors at play in depression, and who is most at risk.
The investigators enrolled 696 residents across 47 nursing homes at the time of their admission. Symptoms of depression were measured twice yearly over 36 months using the Cornell Scale for Depression in Dementia.
Depressive symptoms did not occur in a linear fashion, but followed a distinct trajectory over time, the researchers found. Most residents had persistent mild (33%) or moderate (51%) symptoms. Among the remainder of residents, 5% had increasing symptoms and about 12% had severe but decreasing symptoms.
When compared to the group that had persistent mild depression, five factors were associated with having severe but decreasing symptoms. These included a lower level of functioning, poorer physical health, more pain, use of antidepressants and younger age at admission, Sverre Bergh, MD, PhD, of Innlandet Hospital Trust, Ottestad, Norway, and colleagues reported.
Signs at admission
“This supports the notion that the presence of these factors at admittance is associated with more depressive symptoms over time,” they wrote. Several of the analyses conducted in the study linked the use of antidepressants with more severe symptoms. This “points to an opportunity for more-personalized antidepressant treatment and other possible treatments for depression in nursing home residents,” they concluded.
Notably, their analysis showed that, overall, the residents had more depressive symptoms upon entering the nursing home than they did six months later. Based on prior studies, the time after admission to a nursing home may be the most challenging for vulnerable older adults. This has been labeled “relocation stress syndrome” by the authors of another study.
In the current study, depressive symptoms rose again after 12 months before flattening and again decreasing. This finding may be related to non-mood-related issues, the authors concluded.
Full findings were published in JAMDA.
Related articles:
Nursing home residents prescribed more mental health-related drugs during pandemic
Timely treatment of depression could lower dementia risk, long-term study finds
Pandemic safety measures raised seniors’ risk for depression, anxiety, analysts say
