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Depressive symptoms, physician visits and hospitalization among community-dwelling older adults

Published online by Cambridge University Press:  16 April 2009

Liang Feng ,
Keng Bee Yap ,
Ee Heok Kua  and
Tze Pin Ng
Liang Feng
Affiliation:
Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Gerontological Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Keng Bee Yap
Affiliation:
Gerontological Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Department of Geriatric Medicine, Alexandra Hospital, Singapore
Ee Heok Kua
Affiliation:
Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Gerontological Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Tze Pin Ng*
Affiliation:
Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Gerontological Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
*
Correspondence should be addressed to: Associate Professor Tze-Pin Ng, National University of Singapore, Department of Psychological Medicine, National University Hospital, 5 Lower Kent Ridge Road, Singapore119074. Phone: + 65 67724514; Fax: + 65 67772191. Email: pcmngtp@nus.edu.sg.
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Abstract

Background: The relationship between depressive symptoms and health service use among older people is not well understood. In this study we examined the two-way relationships between depressive symptoms and hospitalization and/or physician visits by older adults.

Methods: In a one-year follow-up study of 973 community-dwelling older adults in the Singapore Longitudinal Aging Studies (SLAS), depressive symptoms (15-item Geriatric Depression Scale score ≥5) were assessed at baseline and one year later. Information on self-reported physician visits and hospitalization were collected bimonthly over one year.

Results: When demographic characteristics, medical comorbidities, functional status and other covariates were controlled for, baseline depressive symptoms were associated with increased episodes of subsequent physician visits during the one-year follow-up (RR,1.34; 95% CI, 1.05–1.70), but not with subsequent hospitalization(s) during the same period. Conversely, participants with five or more physician visits (versus less than 5) over one year were more likely to be depressed at one year (OR, 10.2; 95% CI, 3.36–31.1); hospitalization during this period was also significantly associated with depressive symptoms at one year (OR = 6.43, 95% CI, 2.48–16.6).

Conclusion: Depressive symptoms and health service use have reciprocal relationships. Health service use for non-mental illnesses may be optimized by efforts at post-hospitalization interventions to recognize and treat depression in older persons.

Keywords

depressionphysician visitshospitalization
Type
Research Article
Information
International Psychogeriatrics , Volume 21 , Issue 3 , June 2009 , pp. 568 - 575
Copyright
Copyright © International Psychogeriatric Association 2009

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