Format

Send to

Choose Destination
BMC Geriatr. 2019 Oct 11;19(1):261. doi: 10.1186/s12877-019-1294-9.

Effects of depression, dementia and delirium on activities of daily living in elderly patients after discharge.

Author information

1
Department of Internal Medicine, Division of General Chest Medicine, Hsinchu Cathay General Hospital, Hsinchu, Taiwan.
2
Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan.
3
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
4
Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.
5
Systems Biology and Bioinformatics, National Central University, Taoyuan, Taiwan.
6
Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan. doctord6226@yahoo.com.
7
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. doctord6226@yahoo.com.
8
Superindendent Office, National Taiwan University Hospital Chu-Tung Branch, No.52, Zhishan Rd., Zhudong Township, Hsinchu County, Taiwan, 310. doctord6226@yahoo.com.

Abstract

BACKGROUND:

The three geriatric conditions, depression, dementia and delirium (3D's), are common among hospitalized older patients and often lead to impairments of activities of daily living. The aim of this study is to explore the impact of depression, dementia and delirium on activities of daily living (ADLs) during and after hospitalization.

METHODS:

A prospective cohort study was conducted between 2012 and 2013 in a tertiary medical center in Taiwan. Patients who aged over 65 years and admitted to the geriatric ward were invited to this study. Geriatric Depression Scale Short Form, Mini-Mental State and Confusion Assessment Method were used to identify patients with depression, dementia and delirium on admission, respectively. Barthel Index (BI) was used to evaluate patients' functional status on admission, at discharge, 30-day, 90-day and 180-day after discharge. Generalized Estimating Equation (GEE) was used to calculate the associations between 3 D's and BI.

RESULTS:

One-hundred-and-forty-nine patients were included in this study. Twenty-seven patients (18.1%) had depression, 37 (24.8%) had dementia, and 85 (57.0%) had delirium. The study demonstrated that all the geriatric patients with functional decline presented gradual improvements of physical function up to 180 days after discharge. Whether depression exists did not substantially affect functional recovery after discharge, whilst either dementia or delirium could impede elder people functional status. The recovery of functional improvement in delirium or dementia was relatively irreversible when comparing with depression. Once delirium or dementia was diagnosed, poorer functional restore was expected. In brief, intensive work and strategies on modifying delirium or dementia should be put more effort as early as possible.

CONCLUSIONS:

Old hospitalized patients with depression can recover well after adequate intervention. We emphasize that early detection of dementia and delirium is imperative in subsequent functional outcome, even if at or before admission. Comprehensive plan must be implemented timely.

KEYWORDS:

Functional status; Geriatric syndrome; Hospitalization

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center