Depression predicts functional outcome in geriatric inpatient rehabilitation

Publication date: Available online 13 August 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Saba Shahab, Diana-Felicia Nicolici, Alva Tang, Paul Katz, Linda Mah
ObjectiveTo evaluate the effect of depression on functional recovery in geriatric patients who have completed an inpatient rehabilitation program.DesignProspective cohort study.SettingUniversity-affiliated multidisciplinary, high-tolerance, short-duration geriatric rehabilitation.ParticipantsConvenience sample of 65 patients [mean age 81.6, 25 males] admitted to rehabilitation over a 10-month period. Patients over the age of 60 who were proficient in English and capable of providing informed consent were eligible to participate in the study.InterventionsDepression was assessed using both the Geriatric Depression Scale-Short Form (GDS-15) and the Patient Health Questionnaire (PHQ-9). Measures of well-established predictors of rehabilitation outcome, which may interact with depression, were also obtained and multiple regression linear modeling was used to evaluate the relationship between depression and functional outcome over and above the contribution of these other factors.Main Outcome MeasureFunctional Independence Measure at discharge from the rehabilitation programResultsDepression, as assessed by the GDS-15, but not the PHQ-9, was predictive of functional outcome (standardized β=-.165, p=.021) after controlling for other significant predictors, which included baseline disability, pain, cognition, and educational level. Participation in recreational, but not physio- or occupational, therapy additionally contributed to a small amount of variance in the functional outcome.ConclusionsOur findings suggest that self-report of depression is an independent predictor of functional outcome in high-tolerance, short duration geriatric rehabilitation. Routine assessment of depressive symptoms in older adults using an instrument, such as the GDS-15 may help identify those at risk for poorer outcomes in rehabilitation.



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