DEPRESSION IN GERIATRIC ED PATIENTS - PREVALENCE AND RECOGNITION

Study objective: To determine the prevalence of depression in geriatri c ED patients and to assess recognition of geriatric depression by eme rgency physicians. Methods: We conducted an observational survey of ge riatric patients who presented to an urban, university-affiliate publi c hospital ED. A convenience sample of 259 patients aged 65 years or o lder were administered a brief, self-rated depression scale. Main outc ome measures were prevalence of depression (using a predetermined cuto ff score for detecting depression) and recognition of depression by th e treating emergency physician, assessed by chart review. Results: Sev enty subjects (27%; 95% confidence interval [CI], 22% to 32%) were rat ed as depressed. Depressed and nondepressed patients were not signific antly different with regard to age, sex, race, or education. Forty-sev en percent of nursing home residents were depressed, compared with 24% of those living independently (95% CI for difference of 23%, 6% to 41 %). Patients who described their health as poor were also more likely to be depressed (33 of 65, 51%) than patients who reported their healt h to be good or fair (37 of 194, 29%) (95% CI far difference of 32%, 1 8% to 45%). Emergency physicians failed to recognize depression in all the patients found to be depressed on this scale (95% CI, 0 to 5%). C onclusion: The prevalence of unrecognized depression in the geriatric ED patients we studied was high, especially in those who reported thei r health as poor. Use of a brief depression scale can aid recognition of depression in older patients, reading to appropriate referral and t reatment.