Factors associated with depression in Norwegian nursing homes

Background Depression among patients in nursing homes is frequent and apparently underdiagnosed. Because depression is associated with negative outcomes, identification of groups at risk would improve the diagnosis and potentially improve the prognosis. Aim To confirm or reject the hypothesis that depression in nursing homes is associated with worse medical health, cognitive and functional impairment. Methods A sample of 902 randomly selected nursing-home patients was assessed using the Cornell Scale, the Clinical Dementia Rating Scale (CDR) the Self-Maintenance Scale and a general measurement of medical health. Additionally, information was collected from the patients' records. A multiple linear regression was performed with the Cornell Scale total score, and mood and non-mood subscale scores as the dependent variables. Results In the adjusted analysis, depression according to the Cornell total score was associated with worse medical health (strongest) and worse cognitive impairment (p < 0.001), but not with worse functional impairment. The mood subscale score was associated with worse medical health (strongest, p=0.001), pulmonary diseases (p=0.007), being unmarried (p=0.019) and female gender (p=0.022), but not with worse cognitive impairment. The non-mood subscale score was correlated with cognitive impairment (strongest, p < 0.001), worse medical health (p < 0.001), younger age (p = 0.001), digestive diseases (p = 0.033) and not having suffered from stroke (p = 0.045). Conclusion Our hypothesis was partially confirmed. Worse general medical health was the strongest factor associated with depression, followed by degree of cognitive impairment. Cognitive impairment was not associated with the mood subscale score, but was the strongest correlate for the non-mood symptoms of the Cornell Scale. Copyright (C) 2008 John Wiley & Sons, Ltd.