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Depressive symptoms and the risk of incident delirium in older hospitalized adults.
J Am Geriatr Soc 2007; 55(5):684-91JA

Abstract

OBJECTIVES

To determine whether specific subsets of symptoms from the Geriatric Depression Scale (GDS), assessed at hospital admission, were associated with the incidence of delirium.

DESIGN

Secondary analysis of a prospective cohort study of patients from the Delirium Prevention Trial.

SETTING

General medicine service at Yale New Haven Hospital, March 25, 1995, through March 18, 1998.

PARTICIPANTS

Four hundred sixteen patients aged 70 and older who were at intermediate or high risk for delirium and were not taking antidepressants at hospital admission.

MEASUREMENTS

Depressive symptoms were assessed GDS, and daily assessments of delirium were obtained using the Confusion Assessment Method.

RESULTS

Of the 416 patients in the analysis sample, 36 (8.6%) developed delirium within the first 5 days of hospitalization. Patients who developed delirium reported 5.7 depressive symptoms on average, whereas patients without delirium reported an average of 4.2 symptoms. Using a Cox proportional hazards model, it was found that depressive symptoms assessing dysphoric mood and hopelessness were predictive of incident delirium, controlling for measures of physical and mental health. In contrast, symptoms of withdrawal, apathy, and vigor were not significantly associated with delirium.

CONCLUSION

These findings suggest that assessing symptoms of dysphoric mood and hopelessness could help identify patients at risk for incident delirium. Future studies should evaluate whether nonpharmacological treatment for these symptoms reduces the risk of delirium.

Authors+Show Affiliations

Department of Internal Medicine, School of Medicine, Yale University, New Haven, CT, USA. Gail.McAvay@yale.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17493187

Citation

McAvay, Gail J., et al. "Depressive Symptoms and the Risk of Incident Delirium in Older Hospitalized Adults." Journal of the American Geriatrics Society, vol. 55, no. 5, 2007, pp. 684-91.
McAvay GJ, Van Ness PH, Bogardus ST, et al. Depressive symptoms and the risk of incident delirium in older hospitalized adults. J Am Geriatr Soc. 2007;55(5):684-91.
McAvay, G. J., Van Ness, P. H., Bogardus, S. T., Zhang, Y., Leslie, D. L., Leo-Summers, L. S., & Inouye, S. K. (2007). Depressive symptoms and the risk of incident delirium in older hospitalized adults. Journal of the American Geriatrics Society, 55(5), pp. 684-91.
McAvay GJ, et al. Depressive Symptoms and the Risk of Incident Delirium in Older Hospitalized Adults. J Am Geriatr Soc. 2007;55(5):684-91. PubMed PMID: 17493187.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Depressive symptoms and the risk of incident delirium in older hospitalized adults. AU - McAvay,Gail J, AU - Van Ness,Peter H, AU - Bogardus,Sidney T,Jr AU - Zhang,Ying, AU - Leslie,Douglas L, AU - Leo-Summers,Linda S, AU - Inouye,Sharon K, PY - 2007/5/12/pubmed PY - 2007/6/8/medline PY - 2007/5/12/entrez SP - 684 EP - 91 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 55 IS - 5 N2 - OBJECTIVES: To determine whether specific subsets of symptoms from the Geriatric Depression Scale (GDS), assessed at hospital admission, were associated with the incidence of delirium. DESIGN: Secondary analysis of a prospective cohort study of patients from the Delirium Prevention Trial. SETTING: General medicine service at Yale New Haven Hospital, March 25, 1995, through March 18, 1998. PARTICIPANTS: Four hundred sixteen patients aged 70 and older who were at intermediate or high risk for delirium and were not taking antidepressants at hospital admission. MEASUREMENTS: Depressive symptoms were assessed GDS, and daily assessments of delirium were obtained using the Confusion Assessment Method. RESULTS: Of the 416 patients in the analysis sample, 36 (8.6%) developed delirium within the first 5 days of hospitalization. Patients who developed delirium reported 5.7 depressive symptoms on average, whereas patients without delirium reported an average of 4.2 symptoms. Using a Cox proportional hazards model, it was found that depressive symptoms assessing dysphoric mood and hopelessness were predictive of incident delirium, controlling for measures of physical and mental health. In contrast, symptoms of withdrawal, apathy, and vigor were not significantly associated with delirium. CONCLUSION: These findings suggest that assessing symptoms of dysphoric mood and hopelessness could help identify patients at risk for incident delirium. Future studies should evaluate whether nonpharmacological treatment for these symptoms reduces the risk of delirium. SN - 0002-8614 UR - https://www.unboundmedicine.com/medline/citation/17493187/Depressive_symptoms_and_the_risk_of_incident_delirium_in_older_hospitalized_adults_ L2 - https://doi.org/10.1111/j.1532-5415.2007.01150.x DB - PRIME DP - Unbound Medicine ER -