Effects of depression, dementia and delirium on activities of daily living in elderly patients after discharge
Abstract Background The three geriatric conditions, depression, dementia and delirium (3D’s), are common among hospitalized older patients and often lead to impairments of activities of daily living. The aim of this study is to explore the impact of depression, dementia and delirium on activities of...
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doaj-911f6e5e6a684238a14212701e390af22020-11-25T04:00:46ZengBMCBMC Geriatrics1471-23182019-10-011911810.1186/s12877-019-1294-9Effects of depression, dementia and delirium on activities of daily living in elderly patients after dischargeChing-Fu Weng0Kun-Pei Lin1Feng-Ping Lu2Jen-Hau Chen3Chiung-Jung Wen4Jui-Hua Peng5Ailun Heather Tseng6Ding-Cheng Chan7Department of Internal Medicine, Division of General Chest Medicine, Hsinchu Cathay General HospitalDepartment of Geriatrics and Gerontology, National Taiwan University HospitalDepartment of Geriatrics and Gerontology, National Taiwan University HospitalDepartment of Geriatrics and Gerontology, National Taiwan University HospitalDepartment of Geriatrics and Gerontology, National Taiwan University HospitalDepartment of Geriatrics and Gerontology, National Taiwan University HospitalSystems Biology and Bioinformatics, National Central UniversityDepartment of Geriatrics and Gerontology, National Taiwan University HospitalAbstract Background The three geriatric conditions, depression, dementia and delirium (3D’s), are common among hospitalized older patients and often lead to impairments of activities of daily living. The aim of this study is to explore the impact of depression, dementia and delirium on activities of daily living (ADLs) during and after hospitalization. Methods A prospective cohort study was conducted between 2012 and 2013 in a tertiary medical center in Taiwan. Patients who aged over 65 years and admitted to the geriatric ward were invited to this study. Geriatric Depression Scale Short Form, Mini-Mental State and Confusion Assessment Method were used to identify patients with depression, dementia and delirium on admission, respectively. Barthel Index (BI) was used to evaluate patients’ functional status on admission, at discharge, 30-day, 90-day and 180-day after discharge. Generalized Estimating Equation (GEE) was used to calculate the associations between 3 D’s and BI. Results One-hundred-and-forty-nine patients were included in this study. Twenty-seven patients (18.1%) had depression, 37 (24.8%) had dementia, and 85 (57.0%) had delirium. The study demonstrated that all the geriatric patients with functional decline presented gradual improvements of physical function up to 180 days after discharge. Whether depression exists did not substantially affect functional recovery after discharge, whilst either dementia or delirium could impede elder people functional status. The recovery of functional improvement in delirium or dementia was relatively irreversible when comparing with depression. Once delirium or dementia was diagnosed, poorer functional restore was expected. In brief, intensive work and strategies on modifying delirium or dementia should be put more effort as early as possible. Conclusions Old hospitalized patients with depression can recover well after adequate intervention. We emphasize that early detection of dementia and delirium is imperative in subsequent functional outcome, even if at or before admission. Comprehensive plan must be implemented timely.http://link.springer.com/article/10.1186/s12877-019-1294-9Functional statusGeriatric syndromeHospitalization |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ching-Fu Weng Kun-Pei Lin Feng-Ping Lu Jen-Hau Chen Chiung-Jung Wen Jui-Hua Peng Ailun Heather Tseng Ding-Cheng Chan |
spellingShingle |
Ching-Fu Weng Kun-Pei Lin Feng-Ping Lu Jen-Hau Chen Chiung-Jung Wen Jui-Hua Peng Ailun Heather Tseng Ding-Cheng Chan Effects of depression, dementia and delirium on activities of daily living in elderly patients after discharge BMC Geriatrics Functional status Geriatric syndrome Hospitalization |
author_facet |
Ching-Fu Weng Kun-Pei Lin Feng-Ping Lu Jen-Hau Chen Chiung-Jung Wen Jui-Hua Peng Ailun Heather Tseng Ding-Cheng Chan |
author_sort |
Ching-Fu Weng |
title |
Effects of depression, dementia and delirium on activities of daily living in elderly patients after discharge |
title_short |
Effects of depression, dementia and delirium on activities of daily living in elderly patients after discharge |
title_full |
Effects of depression, dementia and delirium on activities of daily living in elderly patients after discharge |
title_fullStr |
Effects of depression, dementia and delirium on activities of daily living in elderly patients after discharge |
title_full_unstemmed |
Effects of depression, dementia and delirium on activities of daily living in elderly patients after discharge |
title_sort |
effects of depression, dementia and delirium on activities of daily living in elderly patients after discharge |
publisher |
BMC |
series |
BMC Geriatrics |
issn |
1471-2318 |
publishDate |
2019-10-01 |
description |
Abstract Background The three geriatric conditions, depression, dementia and delirium (3D’s), are common among hospitalized older patients and often lead to impairments of activities of daily living. The aim of this study is to explore the impact of depression, dementia and delirium on activities of daily living (ADLs) during and after hospitalization. Methods A prospective cohort study was conducted between 2012 and 2013 in a tertiary medical center in Taiwan. Patients who aged over 65 years and admitted to the geriatric ward were invited to this study. Geriatric Depression Scale Short Form, Mini-Mental State and Confusion Assessment Method were used to identify patients with depression, dementia and delirium on admission, respectively. Barthel Index (BI) was used to evaluate patients’ functional status on admission, at discharge, 30-day, 90-day and 180-day after discharge. Generalized Estimating Equation (GEE) was used to calculate the associations between 3 D’s and BI. Results One-hundred-and-forty-nine patients were included in this study. Twenty-seven patients (18.1%) had depression, 37 (24.8%) had dementia, and 85 (57.0%) had delirium. The study demonstrated that all the geriatric patients with functional decline presented gradual improvements of physical function up to 180 days after discharge. Whether depression exists did not substantially affect functional recovery after discharge, whilst either dementia or delirium could impede elder people functional status. The recovery of functional improvement in delirium or dementia was relatively irreversible when comparing with depression. Once delirium or dementia was diagnosed, poorer functional restore was expected. In brief, intensive work and strategies on modifying delirium or dementia should be put more effort as early as possible. Conclusions Old hospitalized patients with depression can recover well after adequate intervention. We emphasize that early detection of dementia and delirium is imperative in subsequent functional outcome, even if at or before admission. Comprehensive plan must be implemented timely. |
topic |
Functional status Geriatric syndrome Hospitalization |
url |
http://link.springer.com/article/10.1186/s12877-019-1294-9 |
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