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The overlap syndrome of depression and delirium in older hospitalized patients.
J Am Geriatr Soc 2009; 57(8):1347-53JA

Abstract

OBJECTIVES

To measure the prevalence, predictors, and posthospitalization outcomes associated with the overlap syndrome of coexisting depression and incident delirium in older hospitalized patients.

DESIGN

Secondary analysis of prospective cohort data from the control group of the Delirium Prevention Trial.

SETTING

General medical service of an academic medical center. Follow-up interviews at 1 month and 1 year post-hospital discharge.

PARTICIPANTS

Four hundred fifty-nine patients aged 70 and older who were not delirious at hospital admission.

MEASUREMENTS

Depressive symptoms assessed at hospital admission using the 15-item Geriatric Depression Scale (cutoff score of 6 used to define depression), daily assessments of incident delirium from admission to discharge using the Confusion Assessment Method, activities of daily living at admission and 1 month postdischarge, and new nursing home placement and mortality determined at 1 year.

RESULTS

Of 459 participants, 23 (5.0%) had the overlap syndrome, 39 (8.5%) delirium alone, 121 (26.3%) depression alone, and 276 (60.1%) neither condition. In adjusted analysis, patients with the overlap syndrome had higher odds of new nursing home placement or death at 1 year (adjusted odds ratio (AOR)=5.38, 95% confidence interval (CI)=1.57-18.38) and 1-month functional decline (AOR=3.30, 95% CI=1.14-9.56) than patients with neither condition.

CONCLUSION

The overlap syndrome of depression and delirium is associated with significant risk of functional decline, institutionalization, and death. Efforts to identify, prevent, and treat this condition may reduce the risk of adverse outcomes in older hospitalized patients.

Authors+Show Affiliations

Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts 02131, USA. JaneGivens@hrca.harvard.eduNo 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

19558475

Citation

Givens, Jane L., et al. "The Overlap Syndrome of Depression and Delirium in Older Hospitalized Patients." Journal of the American Geriatrics Society, vol. 57, no. 8, 2009, pp. 1347-53.
Givens JL, Jones RN, Inouye SK. The overlap syndrome of depression and delirium in older hospitalized patients. J Am Geriatr Soc. 2009;57(8):1347-53.
Givens, J. L., Jones, R. N., & Inouye, S. K. (2009). The overlap syndrome of depression and delirium in older hospitalized patients. Journal of the American Geriatrics Society, 57(8), pp. 1347-53. doi:10.1111/j.1532-5415.2009.02342.x.
Givens JL, Jones RN, Inouye SK. The Overlap Syndrome of Depression and Delirium in Older Hospitalized Patients. J Am Geriatr Soc. 2009;57(8):1347-53. PubMed PMID: 19558475.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The overlap syndrome of depression and delirium in older hospitalized patients. AU - Givens,Jane L, AU - Jones,Richard N, AU - Inouye,Sharon K, Y1 - 2009/06/03/ PY - 2009/6/30/entrez PY - 2009/6/30/pubmed PY - 2009/9/16/medline SP - 1347 EP - 53 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 57 IS - 8 N2 - OBJECTIVES: To measure the prevalence, predictors, and posthospitalization outcomes associated with the overlap syndrome of coexisting depression and incident delirium in older hospitalized patients. DESIGN: Secondary analysis of prospective cohort data from the control group of the Delirium Prevention Trial. SETTING: General medical service of an academic medical center. Follow-up interviews at 1 month and 1 year post-hospital discharge. PARTICIPANTS: Four hundred fifty-nine patients aged 70 and older who were not delirious at hospital admission. MEASUREMENTS: Depressive symptoms assessed at hospital admission using the 15-item Geriatric Depression Scale (cutoff score of 6 used to define depression), daily assessments of incident delirium from admission to discharge using the Confusion Assessment Method, activities of daily living at admission and 1 month postdischarge, and new nursing home placement and mortality determined at 1 year. RESULTS: Of 459 participants, 23 (5.0%) had the overlap syndrome, 39 (8.5%) delirium alone, 121 (26.3%) depression alone, and 276 (60.1%) neither condition. In adjusted analysis, patients with the overlap syndrome had higher odds of new nursing home placement or death at 1 year (adjusted odds ratio (AOR)=5.38, 95% confidence interval (CI)=1.57-18.38) and 1-month functional decline (AOR=3.30, 95% CI=1.14-9.56) than patients with neither condition. CONCLUSION: The overlap syndrome of depression and delirium is associated with significant risk of functional decline, institutionalization, and death. Efforts to identify, prevent, and treat this condition may reduce the risk of adverse outcomes in older hospitalized patients. SN - 1532-5415 UR - https://www.unboundmedicine.com/medline/citation/19558475/The_overlap_syndrome_of_depression_and_delirium_in_older_hospitalized_patients_ L2 - https://doi.org/10.1111/j.1532-5415.2009.02342.x DB - PRIME DP - Unbound Medicine ER -