Association of depression with malnutrition, grip strength and impaired cognitive function among senior trauma patients

J Affect Disord. 2019 Mar 15:247:175-182. doi: 10.1016/j.jad.2019.01.013. Epub 2019 Jan 15.

Abstract

Background: Depression is common among senior adults, yet understudied among trauma patients. The purpose of this study was to assess the prevalence of depressive symptoms among seniors hospitalized in acute trauma care, to compare patients with depressive symptoms vs. those without, and to evaluate whether depression symptoms affects discharge destination.

Methods: This cross-sectional and prospective analysis was conducted among community-dwelling patients ≥70 years old, hospitalized at the Senior Trauma Center of the University Hospital Zurich, Switzerland. We used the Geriatric Depression Scale (GDS-15) to assess presence of depressive symptoms. Using a cutoff value of 5 points, we compared age- and gender-adjusted characteristics of patients with and without depressive symptoms. Multinomial logistic regression models were used to estimate the odds of returning home vs. not adjusting for age, gender, nutritional status, cognitive function and others.

Results: Of the 273 seniors enrolled, 104 (38.1%) were men and the mean age was 79.4 (SD = 6.5) years. We identified 52 (19.0%) patients with depressive symptoms. These patients were more likely to be older (p = 0.04), at risk for malnutrition (p<0.0001), at least pre-frail (p = 0.005), and have decreased cognitive function (p = 0.001). They were also more than twice as likely to be discharged to acute geriatric care compared to home (OR = 2.28 (CI = 1.12-4.68)).

Limitations: Depressive symptoms were assessed during acute care without data before hospitalization.

Conclusions: Senior trauma patients with depressive symptoms during acute care were more likely to be at higher risk of malnutrition, have cognitive decline and are more likely to receive additional geriatric care.

Keywords: Cognition; Depression; Discharge destination; Elderly; Seniors; Trauma.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Cognition
  • Cognitive Dysfunction / physiopathology
  • Cognitive Dysfunction / psychology*
  • Cross-Sectional Studies
  • Depression / physiopathology
  • Depression / psychology*
  • Female
  • Geriatric Assessment
  • Hand Strength*
  • Humans
  • Independent Living
  • Logistic Models
  • Male
  • Malnutrition / physiopathology
  • Malnutrition / psychology*
  • Nutritional Status
  • Patient Discharge / statistics & numerical data
  • Prevalence
  • Prospective Studies
  • Switzerland
  • Trauma Centers
  • Wounds and Injuries / physiopathology
  • Wounds and Injuries / psychology*