Elderly medical inpatients screening positive for depression may show spontaneous improvement after discharge

Objective: to see whether elderly medical in-patients screening positive for depression on the Geriatric Depression Score show any change on discharge home and whether their scores predict this. Design: a prospective study. Setting: a large outer London district general hospital with acute wards for all medical admissions of people aged over 75 years. Participants: we studied 179 consecutive patients admitted to the acute wards with an abbreviated mental test score of greater than or equal to7 who were resident within the London borough of Waltham Forest. Main outcome measure: Geriatric Depression Scores in hospital and at home after discharge. Account was taken of subsequent psychiatric treatment. Results: 55 inpatients screened positive for depression (15x point Geriatric Depression Score of 5 or more). Repeat screening of these patients, after discharge, resulted in 24 scoring <5 and only 19 scoring greater than or equal to5. Three patients out of the 55 were admitted into psychiatric care with depression prior to follow-up screening. The 15 question Geriatric Depression Score was highly sensitive and the 4 question Geriatric Depression Score highly specific in predicting for depression after discharge. Conclusion: many patients screen positive for depression on acute elderly medical admission wards and nearly half improve spontaneously upon returning home.