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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Loren Greenberg, MD, Antonios Likourezos, MA, MPH, Melinda Lantz, MD, Orah Burack, MA, Eileen Chichin, PhD, RN, and John Carter, MD. Medical Department, The Jewish Home and Hospital, 120 West 106th Street, New York, New York, NY 10025
The objectives of this pilot study were to 1) identify the prevalence of depression in nursing home patients referred to palliative care services and 2) to determine which existing scales that measure depression correlate best with a psychiatric evaluation (gold standard). Patients referred to palliative care were interviewed by a geriatric fellow and a psychiatrist. Both were blinded to each others assessment of depression. Questions asked by the fellow were derived from DSM IV; Geriatric Depression Scale (GDS); Cornell Depression Scale for Dementia (CDS); Visual Analogue Scale (VAS); and Block et al. differentiating grief vs. depression (Block). Cognitive impairment of the patients was measured by the Mini Mental State Examination (MMSE). The patients (70% female) with a median age of 87 years (range: 57 to 100) were primarily refered to palliative care due to complaints of pain (80%). Based on the psychiatrist’s evaluation 45% of the patients had depression and also included patients who were already receiving medications for depression. The median MMSE score was 10.5 (range: 0 to 30). Depression in the most severe dementia patients (MMSE=0) was only able to be assessed by the CDS. However, the CDS poorly correlated with the psychiatrist’s evaluation of depression (45% agreement). The psychiatrist’s evaluation highly correlated with the DSM IV (77% agreement) and GDS (65% agreement). In conclusion, depression was prevalent in the nursing home palliative care patients. Furthermore, to date, no scale is valid and reliable in the most severe dementia patients.
Learning Objectives: At the conclusion of the session, the participant in this session will be able to
Keywords: Dementia, Aging
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Jewish Home and Hosptial and Mount Sinai School of Medicine
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.