Geriatric depression, medical diagnosis, and functional recovery during acute rehabilitation

Objective: To examine and compare the prevalence and functional impact of depressive symptoms for older adult stroke and nonstroke rehabilitation inpatients. Design: Case-control study examining functional outcome using a 2 (stroke, nonstroke) by 2 (depression, no depression) design. Setting: Urban hospital rehabilitation unit. Participants: A total of 509 rehabilitation inpatients (age, >= 60y) were included and grouped by diagnosis of stroke (n = 207) and nonstroke (n = 302). Interventions: Not applicable. Main Outcome Measures: Geriatric Depression Scale and FIM instrument. Analysis of covariance procedures examined the impact of depressive symptoms on discharge functional ability controlling for age, sex, admission functional ability, and hospital length of stay. Results: Prevalence of depressive symptoms was similar for stroke (31.8%) and nonstroke (31.5%) and negatively associated with functional ability at discharge for both groups. Overall, the stroke and nonstroke groups did not differ significantly with respect to functional recovery. Conclusions: Depression, and its impact on acute rehabilitation, is significantly related to functional recovery but does not differ in its frequency or impact for stroke patients. Because depressive symptoms do not appear to discriminate across diagnostic groups, routine screening for depression is recommended for all rehabilitation inpatients.