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Comprehensive Geriatric Care in Older Hospitalized Patients with Depressive Symptoms

Background/Objectives: Depressive symptoms (DS) may interfere with comprehensive geriatric care (CGC), the specific multimodal treatment for older patients. In view of this, the aim of the current study was to investigate the extent to which DS occur in older hospitalized patients scheduled for CGC...

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Autores principales: Niemöller, Ulrich, Arnold, Andreas, Stein, Thomas, Juenemann, Martin, Farzat, Mahmoud, Erkapic, Damir, Rosenbauer, Josef, Kostev, Karel, Meyer, Marco, Tanislav, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10037575/
https://www.ncbi.nlm.nih.gov/pubmed/36960992
http://dx.doi.org/10.3390/geriatrics8020037
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author Niemöller, Ulrich
Arnold, Andreas
Stein, Thomas
Juenemann, Martin
Farzat, Mahmoud
Erkapic, Damir
Rosenbauer, Josef
Kostev, Karel
Meyer, Marco
Tanislav, Christian
author_facet Niemöller, Ulrich
Arnold, Andreas
Stein, Thomas
Juenemann, Martin
Farzat, Mahmoud
Erkapic, Damir
Rosenbauer, Josef
Kostev, Karel
Meyer, Marco
Tanislav, Christian
author_sort Niemöller, Ulrich
collection PubMed
description Background/Objectives: Depressive symptoms (DS) may interfere with comprehensive geriatric care (CGC), the specific multimodal treatment for older patients. In view of this, the aim of the current study was to investigate the extent to which DS occur in older hospitalized patients scheduled for CGC and to analyze the associated factors. Furthermore, we aimed to investigate whether DS are relevant with respect to outcomes after CGC. Methods: For this retrospective study, all patients fulfilling the inclusion criteria were selected by reviewing case files. The main inclusion criterion was the completion of CGC within the defined period (May 2018 and May 2019) in the geriatrics department of the Diakonie Hospital Jung-Stilling Siegen (Germany). The Geriatric Depression Scale was used to asses DS in older adults scheduled for CGC (0–5, no evidence of DS; 6–15 points, DS). Scores for functional assessments (Timed Up and Go test (TuG), Barthel Index, and Tinetti Gait and Balance test) were compared prior to versus after CGC. Factors associated with the presence of DS were studied. Results: Out of the 1263 patients available for inclusion in this study, 1092 were selected for the analysis (median age: 83.1 years (IQR 79.1–87.7 years); 64.1% were female). DS (GDS > 5) were found in 302 patients (27.7%). The proportion of female patients was higher in the subgroup of patients with DS (85.5% versus 76.3%, p = 0.024). Lower rates of patients diagnosed with chronic pulmonary obstructive disease were detected in the subgroup of patients without DS (8.0% versus 14.9%, p = 0.001). Higher rates of dizziness were observed in patients with DS than in those without (9.9% versus 6.2%, p = 0.037). After CGC, TuG scores improved from a median of 4 to 3 (p < 0.001) and Barthel Index scores improved from a median of 45 to 55 (p < 0.001) after CGC in both patients with and without DS. In patients with DS, the Tinetti score improved from a median of 10 (IQR: 4.75–14.25) prior to CGC to 14 (IQR 8–19) after CGC (p < 0.001). In patients without DS, the Tinetti score improved from a median of 12 (IQR: 6–7) prior to CGC to 15 (IQR 2–20) after CGC (p < 0.001). Conclusions: DS were detected in 27.7% of the patients selected for CGC. Although patients with DS had a poorer baseline status, we detected no difference in the degree of improvement in both groups, indicating that the performance of CGC is unaffected by the presence of DS prior to the procedure.
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spelling pubmed-100375752023-03-25 Comprehensive Geriatric Care in Older Hospitalized Patients with Depressive Symptoms Niemöller, Ulrich Arnold, Andreas Stein, Thomas Juenemann, Martin Farzat, Mahmoud Erkapic, Damir Rosenbauer, Josef Kostev, Karel Meyer, Marco Tanislav, Christian Geriatrics (Basel) Article Background/Objectives: Depressive symptoms (DS) may interfere with comprehensive geriatric care (CGC), the specific multimodal treatment for older patients. In view of this, the aim of the current study was to investigate the extent to which DS occur in older hospitalized patients scheduled for CGC and to analyze the associated factors. Furthermore, we aimed to investigate whether DS are relevant with respect to outcomes after CGC. Methods: For this retrospective study, all patients fulfilling the inclusion criteria were selected by reviewing case files. The main inclusion criterion was the completion of CGC within the defined period (May 2018 and May 2019) in the geriatrics department of the Diakonie Hospital Jung-Stilling Siegen (Germany). The Geriatric Depression Scale was used to asses DS in older adults scheduled for CGC (0–5, no evidence of DS; 6–15 points, DS). Scores for functional assessments (Timed Up and Go test (TuG), Barthel Index, and Tinetti Gait and Balance test) were compared prior to versus after CGC. Factors associated with the presence of DS were studied. Results: Out of the 1263 patients available for inclusion in this study, 1092 were selected for the analysis (median age: 83.1 years (IQR 79.1–87.7 years); 64.1% were female). DS (GDS > 5) were found in 302 patients (27.7%). The proportion of female patients was higher in the subgroup of patients with DS (85.5% versus 76.3%, p = 0.024). Lower rates of patients diagnosed with chronic pulmonary obstructive disease were detected in the subgroup of patients without DS (8.0% versus 14.9%, p = 0.001). Higher rates of dizziness were observed in patients with DS than in those without (9.9% versus 6.2%, p = 0.037). After CGC, TuG scores improved from a median of 4 to 3 (p < 0.001) and Barthel Index scores improved from a median of 45 to 55 (p < 0.001) after CGC in both patients with and without DS. In patients with DS, the Tinetti score improved from a median of 10 (IQR: 4.75–14.25) prior to CGC to 14 (IQR 8–19) after CGC (p < 0.001). In patients without DS, the Tinetti score improved from a median of 12 (IQR: 6–7) prior to CGC to 15 (IQR 2–20) after CGC (p < 0.001). Conclusions: DS were detected in 27.7% of the patients selected for CGC. Although patients with DS had a poorer baseline status, we detected no difference in the degree of improvement in both groups, indicating that the performance of CGC is unaffected by the presence of DS prior to the procedure. MDPI 2023-03-12 /pmc/articles/PMC10037575/ /pubmed/36960992 http://dx.doi.org/10.3390/geriatrics8020037 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Niemöller, Ulrich
Arnold, Andreas
Stein, Thomas
Juenemann, Martin
Farzat, Mahmoud
Erkapic, Damir
Rosenbauer, Josef
Kostev, Karel
Meyer, Marco
Tanislav, Christian
Comprehensive Geriatric Care in Older Hospitalized Patients with Depressive Symptoms
title Comprehensive Geriatric Care in Older Hospitalized Patients with Depressive Symptoms
title_full Comprehensive Geriatric Care in Older Hospitalized Patients with Depressive Symptoms
title_fullStr Comprehensive Geriatric Care in Older Hospitalized Patients with Depressive Symptoms
title_full_unstemmed Comprehensive Geriatric Care in Older Hospitalized Patients with Depressive Symptoms
title_short Comprehensive Geriatric Care in Older Hospitalized Patients with Depressive Symptoms
title_sort comprehensive geriatric care in older hospitalized patients with depressive symptoms
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10037575/
https://www.ncbi.nlm.nih.gov/pubmed/36960992
http://dx.doi.org/10.3390/geriatrics8020037
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