Depression and associated factors in hospitalized elderly: a cross-sectional study in a Saudi teaching hospital

BACKGROUND: Depression in the elderly is a serious and often underdiagnosed psychiatric disorder that has been linked to adverse outcomes in the hospital setting. OBJECTIVES: To determine the prevalence of depression and possible associated factors among hospitalized elderly. DESIGN: An analytical cross-sectional study. SETTINGS: Medical and surgical wards of King Abdulaziz University Hospital, Jeddah, Saudi Arabia. PATIENTS AND METHODS: The study included 200 consecutively hospitalized patients aged 60 years and older. Participants were evaluated within 48 hours of admission using an interviewer-administered questionnaire to provide basic demographic and clinical information. MAIN OUTCOME MEASURE(S): Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9) screening method and the Structured Clinical Interview for the Diagnostic and Statistical Manual, Fifth Edition (DSM-5) mood disorder module. RESULTS: According to PHQ-9, 17% and 10.5% of the hospitalized patients were diagnosed with a major depressive disorder and other depressive disorders, respectively. The DSM-5 criteria identified 12% of elderly with major depression. Overall, the number of comorbidities associated with depression was significantly higher in the major depressive disorder group than in the no depression group (post hoc P=.022). Depression was also associated with female gender, unmarried status, lower income, and polypharmacy. In addition, cardiovascular disease and cancer were the most prevalent medical illnesses associated with depression among hospitalized elderly. CONCLUSION: Major depressive disorder was prevalent among hospitalized elderly, especially among those with comorbid conditions. Hospital physicians must, therefore, maintain a high index of suspicion to identify early and manage depressive symptoms in these patients. LIMITATION: The small size of certain subgroups limits the statistical power to examine for associations of depression with particular conditions.