Objective: to examine the relationship between depressive symptoms and hospital outcomes in an unselected consecutive sample of older medical inpatients.
Design: a prospective cohort study of individuals screened for a trial.
Setting: medical wards of UK district general hospital in rural East Anglia.
Participants: six hundred and seventeen medical inpatients aged 65+ were randomly selected from consecutive admissions. Baseline measures: 15-item Geriatric Depression Scale (GDS-15), the Abbreviated Mental Test Score (AMTS) and the Cumulative Illness Rating Scale-Geriatric (CIRS-G).
Main outcome measures: length of hospital stay; discharge to a community hospital (for rehabilitation), institutional care or usual place of residence; dying in hospital.
Results: depressive symptoms are independently associated with an increased likelihood of inpatient death and transfer to a community hospital for rehabilitation, but are not associated with longer length of stay.
Conclusions: research evaluating effectiveness of identification and treatment of depression in older medical inpatients should consider including inpatient death and use of rehabilitation services as potential outcomes.