Depressive Symptoms and Hospital Readmission in Older Adults

ObjectivesTo quantify the risk of 30-day unplanned hospital readmission in adults aged 65 and older with depressive symptoms. DesignProspective cohort study. SettingUniversity of Maryland Medical Center. ParticipantsIndividuals aged 65 and older admitted between July 1, 2011, and August 9, 2012, to the general medical and surgical units and followed for 31days after hospital discharge (N=750). MeasurementsPrimary exposure was depressive symptoms at admission, defined as a score of 6 or more on the 15-item Geriatric Depression Scale. Primary outcome was unplanned 30-day hospital readmission, defined as an unscheduled overnight stay at any inpatient facility not occurring in the emergency department. ResultsPrevalence of depressive symptoms was 19% and incidence of 30-day unplanned hospital readmission was 19%. Depressive symptoms were not significantly associated with hospital readmission (relative risk (RR)=1.20, 95% confidence interval (CI)=0.83-1.72). Age, Charlson Comorbidity Index score, and number of hospitalizations within the past 6months were significant predictors of unplanned 30-day hospital readmission. ConclusionAlthough not associated with hospital readmission, depressive symptoms were associated with other poor outcomes and may be underdiagnosed in hospitalized older adults. Hospitals interested in reducing readmission should focus on older adults with more comorbid illness and recent hospitalizations.