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.