Accuracy of recognition and diagnosis of comorbid depression in the nursing home

A variety of research has documented high levels of depression among older adults in the health care setting. Additional research has shown that care providers in health care settings are not very effective at diagnosing como rbid depression. This is a troublesome finding since comorbid depression ha s been linked to a number of negative outcomes in older adults. Early resul ts have indicated that comorbid depression may be associated with a number of unfavorable consequences ranging from impairments in physical functionin g to increased mortality. The health care setting with arguably the highest rate of physical impairment is the nursing home and it is the nursing home where the effects of comorbid depression may be most costly. Therefore, th e current analysis uses data from the Institutional Population Component of the National Medical Expenditure Survey (US Department of Health and Human Services, 1990) to explore rates of both recognized and unrecognized comor bid depression in the nursing home setting. Using a constructed proxy varia ble representative of the DSM-III-R diagnosis of depression, results indica te that approximately 8.1% of nursing home residents have an unrecognized p otential comorbid depression.