A comparison of depressive symptoms in elderly medical inpatients and the elderly in a population-based health study (the Nord-Trondelag Health Study 3)

Aim: To compare depression in a sample of the medically hospitalized elderly with elderly people participating in a population-based health study in Norway and further to study the odds for depression, controlling for demographic and health differences between the two samples. Method: This cross-sectional observational study evaluated 484 medical inpatients from rural areas and 10,765 drawn from the Nord-Trondelag Health Study 3 (HUNT-3 Study) including participants from rural and urban areas. All participants were elderly (>= 65 years) with a mean (+/- standard deviation) age of 80.7 +/- 7.4 and 73.3 +/- 6.3 years, respectively. Symptoms of depression were screened by the Hospital Anxiety and Depression Scale (HAD). Results: The prevalence of symptoms indicating mild, moderate or more severe depression (depression score >= 8) was about the same in both groups. In regression analyses, adjusting demographic and health differences, the odds for depression was lower for the elderly in the hospital sample than in the HUNT-3 Study. Older age, male gender, perceiving general health as poor, having impaired ability to function in daily life, previous consultation or treatment for emotional problems and anxiety (anxiety score >= 8) were associated with increased odds for depression in the elderly independent of being hospitalized or not. Conclusion: Surprisingly, we found the odds for depression after controlling for demographic and health variables to be lower in the hospitalized elderly individuals than in the elderly participating in the population-based health study. The health variables that were most strongly associated with an increased risk of depression were poor physical health and anxiety.