The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #53321

Yael Harris, PhD, MHS, Quality Mesures and Health Assessment Group, Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Mailstop S3-02-01, Baltimore, MD 21244-1850, 410-786-9045, yharris@cms.hhs.gov

BACKGROUND: Depression is one of the most common mental illnesses in older Americans. Depression has been associated with increased co-morbidities, hospitalizations, and death. However, most cases go undetected and untreated. DATASETS: This study utilized the Health Outcomes Survey, the Minimum Data Set for Nursing Homes, the Medicare Enrollment Database, and the Online Survey and Certification Reporting System to evaluate the risk of entering a nursing home for Medicare managed care enrollees who identified themselves as experiencing symptoms of depression or anhedonia. METHODS: This study employed a series of cox proportional hazard models to allow for time varying covariates. RESULTS: The results indicate that even when controlling for functional impairments, chronic health, and social and environmental factors, individuals who exhibit symptoms of depression are at an increased risk of entering a nursing home. This effect is even greater for those who suffer from anhedonia. The results also suggest an interaction between age and depressive symptoms, functional status and depressive symptoms, and chronic health and depressive symptoms which increases the risk of entering a nursing home at an earlier date. DISCUSSION: These findings emphasize the need for better screening of mental health in seniors with a possible cost-offset effect if early detection of depressive symptoms can reduce the number of seniors admitted to nursing homes or delay an inevitable need for admission.

Learning Objectives:

At the conclusion of this session, the participant will be able to:
• recognize the relationship between depression and nursing home admissions
• assess the relationship between depression and physical health, functional health, or age and how these relate to future use of nursing home services
• evaluate the current approaches to treatment of depression and articulate ways in which we can improve the quality of life for seniors by identifying and treating depression in the community

Keywords: Depression, Nursing Homes

Presenting author's disclosure statement:
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.