Advertisement
Editorial| Volume 11, ISSUE 5, P301-303, June 2010

Download started.

Ok

Depression in Nursing Home Residents

  • John E. Morley
    Correspondence
    Address correspondence to John E. Morley, MB, BCh, Division of Geriatric Medicine, Saint Louis University School of Medicine, 1402 S. Grand Boulevard, M238, St. Louis, MO 63104.
    Affiliations
    Division of Geriatric Medicine, Saint Louis University School of Medicine and GRECC, VA Medical Center, St. Louis, MO
    Search for articles by this author
      Depression is an extremely common problem in nursing homes.
      • Messinger-Rapport B.J.
      • Thomas D.R.
      • Gammack J.K.
      • Morley J.E.
      Clinical update on nursing home medicine.
      In a recent study in the Journal, 48% of residents in Ohio nursing homes were depressed.
      • Levin C.A.
      • Wei W.
      • Akincigil A.
      • et al.
      Prevalence and treatment of diagnosed depression among elderly nursing home residents in Ohio.
      Of these residents, 23.0% were not treated and only 2.5% received some form of behavioral therapy. African Americans and persons with dementia were the least likely to be diagnosed and treated. The failure to diagnose and treat African Americans with depression is also a common occurrence in the community.
      • Miller D.K.
      • Malmstrom T.K.
      • Joshi S.
      • et al.
      Clinically relevant levels of depressive symptoms in community-dwelling middle-aged African Americans.
      Not surprisingly, nursing home residents tend to be less depressed than those at home.
      • Karakaya M.G.
      • Bilgin S.C.
      • Ekici G.
      • et al.
      Functional mobility, depressive symptoms, level of independence, and quality of life of the elderly living at home and in the nursing home.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of the American Medical Directors Association
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Messinger-Rapport B.J.
        • Thomas D.R.
        • Gammack J.K.
        • Morley J.E.
        Clinical update on nursing home medicine.
        J Am Med Dir Assoc. 2009; 2009: 530-553
        • Levin C.A.
        • Wei W.
        • Akincigil A.
        • et al.
        Prevalence and treatment of diagnosed depression among elderly nursing home residents in Ohio.
        J Am Med Dir Assoc. 2007; 8: 585-594
        • Miller D.K.
        • Malmstrom T.K.
        • Joshi S.
        • et al.
        Clinically relevant levels of depressive symptoms in community-dwelling middle-aged African Americans.
        J Am Geriatr Soc. 2004; 52: 741-748
        • Karakaya M.G.
        • Bilgin S.C.
        • Ekici G.
        • et al.
        Functional mobility, depressive symptoms, level of independence, and quality of life of the elderly living at home and in the nursing home.
        J Am Med Dir Assoc. 2009; 10: 662-666
        • Damian J.
        • Pastor-Barriuso R.
        • Valderrama-Gama E.
        Descriptive epidemiology of undetected depression in institutionalized older people.
        J Am Med Dir Assoc. 2010; 11: 312-319
        • Volicer L.
        • Van der Steen J.T.
        • Frijters D.H.
        Modifiable factors related to abusive behaviors in nursing home residents with dementia.
        J Am Med Dir Assoc. 2009; 10: 617-622
        • Mansdorf I.J.
        • Harrington M.
        • Lund J.
        • Wohl N.
        Neuropsychological testing in skilled nursing facilities: The failure to confirm diagnoses of dementia.
        J Am Med Dir Assoc. 2008; 9: 271-274
        • Locca J.F.
        • Bula C.J.
        • Zumbach S.
        • Bugnon O.
        Pharmacological treatment of behavioral and psychological symptoms of dementia (BPSD) in nursing homes: Development of practice recommendations in a Swiss canton.
        J Am Med Dir Assoc. 2008; 9: 439-448
        • Volicer L.
        • Bass E.A.
        • Luther S.L.
        Agitation and resistiveness to care are two separate behavioral syndromes of dementia.
        J Am Med Dir Assoc. 2007; 8: 527-532
        • Samus Q.M.
        • Mayer L.
        • Onyike C.U.
        • et al.
        Correlates of functional dependence among recently admitted assisted living residents with and without dementia.
        J Am Med Dir Assoc. 2009; 10: 323-329
        • Young Y.
        Factors associated with permanent transition from independent living to nursing home in a continuing care retirement community.
        J Am Med Dir Assoc. 2009; : 491-497
        • Fusco D.
        • Bochicchio G.B.
        • Onder G.
        • et al.
        SILVERNET-HC Study Group of Basilicata Region. Predictors of rehabilitation outcome among frail elderly patients living in the community.
        J Am Med Dir Assoc. 2009; 10: 335-341
        • Bellelli G.
        • Magnifico F.
        • Trabucchi M.
        Outcomes at 12 months in a population of elderly patients discharged from a rehabilitation unit.
        J Am Med Dir Assoc. 2008; 9: 55-64
        • Thakur M.
        • Blazer D.G.
        Depression in long-term care.
        J Am Med Dir Assoc. 2008; 9: 82-87
        • Morley J.E.
        Weight loss in the nursing home.
        J Am Med Dir Assoc. 2007; 8: 201-204
        • Nijs K.
        • de Graaf C.
        • van Staveren W.A.
        • de Groot L.C.
        Malnutrition and mealtime ambiance in nursing homes.
        J Am Med Dir Assoc. 2009; 10: 226-229
        • Cabrera M.A.
        • Mesas A.E.
        • Garcia A.R.
        • de Andrade S.M.
        Malnutrition and depression among community-dwelling elderly people.
        J Am Med Dir Assoc. 2007; 8: 582-584
        • Sloane P.D.
        • Ivey J.
        • Helton M.
        • et al.
        Nutritional issues in long-term care.
        J Am Med Dir Assoc. 2008; 9: 476-485
        • Morley J.E.
        • Kraenzle D.
        Causes of weight loss in a community nursing home.
        J Am Geriatr Soc. 1994; 42: 583-585
        • Wilson M.M.
        • Vaswani S.
        • Liu D.
        • et al.
        Prevalence and causes of undernutrition in medical outpatients.
        Am J Med. 1998; 104: 56-63
        • Thomas D.R.
        • Ashmen W.
        • Morley J.E.
        • Evans W.J.
        Nutritional management in long-term care: Development of a clinical guideline. Council for Nutritional Strategies in Long-term Care.
        J Gerontol A Biol Sci Med Sci. 2000; 55: M725-M734
        • Morley J.E.
        • Levine A.S.
        Bombesin inhibits stress-induced eating.
        Pharmacol Biochem Behav. 1981; 14: 149-151
        • Morley J.E.
        • Levine A.S.
        The pharmacology of eating behavior.
        Annu Rev Pharmacol Toxicol. 1985; 25: 127-146
        • Fitten L.J.
        • Morley J.E.
        • Gross P.L.
        • et al.
        Depression. J Am Geriatr Soc. 1989; 37: 459-472
        • Meyers R.M.
        • Reger L.
        Diabetes management in long-term care facilities: A practical guide.
        J Am Med Dir Assoc. 2009; 10: 589
        • Rosenthal M.J.
        • Fajardo M.
        • Gilmore S.
        • et al.
        Hospitalization and mortality of diabetes in older adults. A 3-year prospective study.
        Diabetes Care. 1998; 21: 231-235
        • Mazza A.D.
        • Morley J.E.
        Update on diabetes in the elderly and the application of current therapeutics.
        J Am Med Dir Assoc. 2007; 8: 489-492
        • Colberg S.R.
        • Somma C.T.
        • Sechrist S.R.
        Physical activity participation may offset some of the negative impact of diabetes on cognitive function.
        J Am Med Dir Assoc. 2008; 9: 434-438
        • Leone A.F.
        • Standoli F.
        • Hirth V.
        Implementing a pain management program in a long-term care facility using a quality improvement approach.
        J Am Med Dir Assoc. 2009; 10: 67-73
        • Morley J.E.
        Hot topics in geriatrics.
        J Am Med Dir Assoc. 2008; 9: 613-616
        • Flaherty J.H.
        • Shay K.
        • Weir C.
        • et al.
        The development of a mental status vital sign for use across the spectrum of care.
        J Am Med Dir Assoc. 2009; 10: 379-380
        • Flaherty J.H.
        • Rudolph J.
        • Shay K.
        • et al.
        Delirium is a serious and under-recognized problem: Why assessment of mental status should be the sixth vital sign.
        J Am Med Dir Assoc. 2007; 8: 273-275
        • Lewis L.M.
        • Miller D.K.
        • Morley J.E.
        • et al.
        Unrecognized delirium in ED geriatric patients.
        Am J Emerg Med. 1995; 13: 142-145
        • Morley J.E.
        Developing novel therapeutic approaches to frailty.
        Curr Pharm Des. 2009; 15: 3384-3395
        • Abellan van Kan G.
        • Rolland Y.M.
        • Morley J.E.
        • Vellas B.
        Frailty: Toward a clinical definition.
        J Am Med Dir Assoc. 2008; 9: 71-72
        • Abellan van Kan G.
        • Rolland Y.
        • Bergman
        • et al.
        The I.A.N.A. Task Force on frailty assessment of older people in clinical practice.
        J Nutr Health Aging. 2008; 12: 29-37
        • Evans W.J.
        • Morley J.E.
        • Argiles J.
        • et al.
        Cachexia: A new definition.
        Clin Nutr. 2008; 27: 793-799
        • Morley J.E.
        Thomas DR. Cachexia: New advances in the management of wasting diseases.
        J Am Med Dir Assoc. 2008; 9: 205-210
        • Morley J.E.
        Androgens and aging.
        Maturitas. 2001; 38: 61-71
        • Haren M.T.
        • Malmstrom T.K.
        • Banks W.A.
        • et al.
        Lower serum DHEAS levels are associated with a higher degree of physical disability and depressive symptoms in middle-aged to older African American women.
        Maturitas. 2007; 57: 347-360
        • Morley J.E.
        • Perry 3rd, H.M.
        • Kevorkian R.T.
        • Patrick P.
        Comparison of screening questionnaires for the diagnosis of hypogonadism.
        Maturitas. 2006; 53: 424-429
        • Wang C.
        • Nieschlag E.
        • Swerdloff R.
        • et al.
        Investigation, treatment and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA and ASA recommendations.
        Eur J Endocrinol. 2008; 159: 507-514
        • Morley J.E.
        Impotence. Am J Med. 1986; 80: 897-905
        • Aman E.
        • Thomas D.R.
        Supervised exercise to reduce agitation in severely cognitively impaired persons.
        J Am Med Dir Assoc. 2009; 10: 271-276
        • Morley J.E.
        The magic of exercise.
        J Am Med Dir Assoc. 2008; 9: 271-274
        • Rolland Y.
        • Abelland van Kan G.
        • Vellas B.
        Physical activity and Alzheimer's disease: From prevention to therapeutic perspectives.
        J Am Med Dir Assoc. 2008; 9: 390-405
        • Morley J.E.
        Managing persons with dementia in the nursing home: High touch trumps high tech.
        J Am Med Dir Assoc. 2008; 9: 139-146
        • Greer T.L.
        • Trivedi M.H.
        Exercise in the treatment of depression.
        Curr Psychiatry Rep. 2009; 11: 466-472
        • Flaherty J.H.
        • McBride M.
        • Marzouk S.
        • et al.
        Decreasing hospitalization rates for older home care patients with symptoms of depression.
        J Am Geriatr Soc. 1998; 46: 31-38
        • Morley J.E.
        Polypharmacy in the nursing home.
        J Am Med Dir Assoc. 2009; 10: 289-291
        • Hanlon J.T.
        • Handler S.M.
        • Castle N.G.
        Antidepressant prescribing in U.S. nursing homes between 1996 and 2006 and its relationship to staffing patterns and use of psychotropic medications.
        J Am Med Dir Assoc. 2010; 11: 320-324
        • Arroll B.
        • Elley C.R.
        • Fishman T.
        • et al.
        Antidepressants versus placebo for depression in primary care.
        Cochrane Database Syst Rev. 2009; : CD007954
        • Cipriani A.
        • La Ferla T.
        • Furukawa T.A.
        • et al.
        Sertraline versus other antidepressive agents for depression.
        Cochrane Database Syst Rev. 2010; (CD006117)
        • Iwanzcyk L.
        • Weintraub N.T.
        • Rubenstein L.Z.
        Orthostatic hypotension in the nursing home setting.
        J Am Med Dir Assoc. 2006; 7: 163-167
        • Mukai Y.
        • Tampi R.R.
        Treatment of depression in the elderly: A review of the recent literature on the efficacy of single- versus dual-action antidepressants.
        Clin Ther. 2009; 31: 945-961
        • Papakostas G.I.
        • Thase M.E.
        • Fava M.
        • Nelson J.C.
        • Shelton R.C.
        Are antidepressant drugs that combine serotonergic and noradrenergic mechanisms of action more effective than the selective serotonin reuptake inhibitors in treating major depressive disorder? A meta-analysis of studies of newer agents.
        Biol Psychiatry. 2007; 62: 1217-1227
        • Watanabe N.
        • Omori I.M.
        • Nakagawa A.
        • et al.
        Safety reporting and adverse-event profile of mirtazapine described in randomized controlled trials in comparison with other classes of antidepressants in the acute-phase treatment of adults with depression: Systematic review and meta-analysis.
        CNS Drugs. 2010; 24: 35-53
        • Uk Ect. Review Group
        Efficacy and safety of electroconvulsive therapy in depressive disorders: A systematic review and meta-analysis.
        Lancet. 2003; 361: 799-808
        • Van der Wurff F.B.
        • Stek M.L.
        • Hoogendijk W.L.
        • Beekman A.T.
        Electroconvulsive therapy for the depressed elderly.
        Cochrane Database Syst Rev. 2003; : CD003593
        • Loo C.K.
        • McFarquhar T.F.
        • Mitchell P.B.
        A review of the safety of repetitive transcranial magnetic stimulation as a clinical treatment for depression.
        Int J Neuropsychopharmacol. 2008; 11: 131-147
        • Watson L.C.
        • Pignone M.P.
        Screening accuracy for late-life depression in primary care: A systematic review.
        J Fam Pract. 2003; 52: 956-964
        • Tariq S.H.
        • Tumosa N.
        • Chibnall J.T.
        • et al.
        Comparison of the Saint Louis University mental status examination and the mini-mental state examination for detecting dementia and mild neurocognitive disorder—a pilot study.
        Am J Geriatr Psychiatry. 2006; 14: 900-910
        • Alexopoulos G.S.
        • Abrams R.C.
        • Young R.C.
        • Shamoian C.A.
        Cornell scale for depression in dementia.
        Biol Psychiatry. 1988; 23: 271-284
        • Cuijpers P.
        • Dekker J.
        • Hollon S.D.
        • Andersson G.
        Adding psychotherapy to pharmacotherapy in the treatment of depressive disorders in adults: A meta-analysis.
        J Clin Psychiatry. 2009; 70: 1219-1229