Feature Article

Indicators of a New Depression Diagnosis in Nursing Home Residents

Lorraine J. Phillips, PhD, RN, FNP-BC; Marilyn Rantz, PhD, RN, FAAN; Gregory F. Petroski, PhD

  • Journal of Gerontological Nursing
  • January 2011 - Volume 37 · Issue 1: 42-52
  • DOI: 10.3928/00989134-20100702-03
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Abstract

Depression affects approximately 30% to 40% of nursing home residents but frequently goes unrecognized. Using the Missouri Minimum Data Set, we aimed to determine whether changes in clinical status, other than mood changes, were associated with new depression diagnosis in residents 65 and older without a recorded depression diagnosis. Of 127,587 potential participants, 14,371 met inclusion criteria and were not depressed at baseline (Time 0). At the next quarterly assessment (Time 1), 1,342 (9.3%) had acquired a new diagnosis of depression. Residents with new depression were significantly younger and less cognitively impaired. Nearly 30% had a decline in activities of daily living (ADL) performance. The multivariate model predicting depression showed that increased verbal aggression, urinary incontinence, increased pain, weight loss, change in care needs, cognitive decline, and ADL decline significantly increased the likelihood of new depression diagnosis. The pattern of decline identified here may provide additional clues to the presence of underlying depression.

AUTHORS

Dr. Phillips is John A. Hartford Foundation Claire M. Fagin Fellow and Assistant Professor, Dr. Rantz is Professor and Helen E. Nahm Chair, Sinclair School of Nursing, University Hospitals and Clinics Professor of Nursing, Executive Director, Aging In Place, and Associate Director, Interdisciplinary Center on Aging, and Dr. Petroski is Research Assistant Professor of Biostatistics and Statistician, Office of Medical Research, University of Missouri, Columbia, Missouri.

The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity. This work was funded by the University of Missouri MDS and Quality Research Team, Marilyn Rantz, PhD, RN, FAAN, Chair, and the John A. Hartford Foundation’s Building Academic Geriatric Nursing Capacity award program.

Address correspondence to Lorraine J. Phillips, PhD, RN, FNP-BC, John A. Hartford Foundation Claire M. Fagin Fellow and Assistant Professor, S414 Sinclair School of Nursing, University of Missouri, Columbia, MO 65211; e-mail: .phillipslo@missouri.edu

doi: 10.3928/00989134-20100702-03

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