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Six-month trajectories of self-reported depressive symptoms in long-term care

Published online by Cambridge University Press:  10 August 2015

Jane McCusker ,
Martin G. Cole ,
Philippe Voyer ,
Johanne Monette ,
Nathalie Champoux ,
Antonio Ciampi ,
Minh Vu ,
Eric Belzile  and
Chun Bai
Jane McCusker*
Affiliation:
St. Mary's Research Centre, St. Mary's Hospital Center, Montreal, Quebec, Canada Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
Martin G. Cole
Affiliation:
Department of Psychiatry, St Mary's Hospital and McGill University, Montreal, Quebec, Canada
Philippe Voyer
Affiliation:
Faculty of Nursing Sciences, Laval University, Quebec City, Quebec, Canada
Johanne Monette
Affiliation:
Division of Geriatric Medicine, Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada Donald Berman Maimonides Geriatric Center, Montreal, Quebec, Canada
Nathalie Champoux
Affiliation:
Département de Médecine Familiale, Université de Montréal, Montreal, Quebec, Canada
Antonio Ciampi
Affiliation:
St. Mary's Research Centre, St. Mary's Hospital Center, Montreal, Quebec, Canada Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
Minh Vu
Affiliation:
Division of Geriatric Medicine, Centre Hospitalier de l’Université de Montréal, and Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
Eric Belzile
Affiliation:
St. Mary's Research Centre, St. Mary's Hospital Center, Montreal, Quebec, Canada
Chun Bai
Affiliation:
St. Mary's Research Centre, St. Mary's Hospital Center, Montreal, Quebec, Canada
*
Correspondence should be addressed to: Dr. J. McCusker, St. Mary's Research Centre, 3830 Avenue Lacombe #4720, Montreal, Quebec H3 T 1M5, Canada. Phone: +514-345-3511-5062; Fax: +514-734-2652. Email: jane.mccusker@mcgill.ca.
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Abstract

Background:

Depression is a common problem in long-term care (LTC) settings. We sought to characterize depression symptom trajectories over six months among older residents, and to identify resident characteristics at baseline that predict symptom trajectory.

Methods:

This study was a secondary analysis of data from a six-month prospective, observational, and multi-site study. Severity of depressive symptoms was assessed with the 15-item Geriatric Depression Scale (GDS) at baseline and with up to six monthly follow-up assessments. Participants were 130 residents with a Mini-Mental State Examination score of 15 or more at baseline and of at least two of the six monthly follow-up assessments. Individual resident GDS trajectories were grouped using hierarchical clustering. The baseline predictors of a more severe trajectory were identified using the Proportional Odds Model.

Results:

Three clusters of depression symptom trajectory were found that described “lower,” “intermediate,” and “higher” levels of depressive symptoms over time (mean GDS scores for three clusters at baseline were 2.2, 4.9, and 9.0 respectively). The GDS scores in all groups were generally stable over time. Baseline predictors of a more severe trajectory were as follows: Initial GDS score of 7 or more, female sex, LTC residence for less than 12 months, and corrected visual impairment.

Conclusions:

The six-month course of depressive symptoms in LTC is generally stable. Most residents who experience a more severe symptom trajectory can be identified at baseline.

Keywords

aged caredepressionlongitudinal studieslong-term care
Type
Research Article
Information
International Psychogeriatrics , Volume 28 , Issue 1 , January 2016 , pp. 71 - 81
Copyright
Copyright © International Psychogeriatric Association 2015 

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