Depression symptoms and cognitive impairment in older nursing home residents in the USA: A latent class analysis
Student Authors
Yiyang YuanAcademic Program
Clinical and Population Health ResearchUMass Chan Affiliations
PsychiatryPopulation and Quantitative Health Sciences
Graduate School of Biomedical Sciences
Biostatistics and Health Services Research
UMass Chan Analytics
Document Type
Journal ArticlePublication Date
2020-04-06Keywords
cognitive impairmentdepression
latent class analysis
nursing home
Geriatrics
Psychiatry and Psychology
Metadata
Show full item recordAbstract
OBJECTIVES: To identify subgroups of nursing home (NH) residents in the USA experiencing homogenous depression symptoms and evaluate if subgroups vary by cognitive impairment. METHODS: We identified 104 465 newly admitted, long-stay residents with depression diagnosis at NH admission in 2014 using the Minimum Data Set 3.0. The Patient Health Questionnaire-9 was used to measure depression symptoms and the Brief Interview of Mental Status for cognitive impairment (intact; moderately impaired; severely impaired). Latent class analysis (LCA) with logistic regression was used to: (a) construct the depression subgroups and (b) estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) of the associations between the subgroups and cognitive impairment level, adjusting for demographic and clinical characteristics. RESULTS: The best-fitted LCA model suggested four subgroups of depression: minimal symptoms (latent class prevalence: 42.4%), fatigue (32.0%), depressed mood (14.5%), and multiple symptoms (11.2%). Odds of subgroup membership varied by cognitive impairment. Compared to residents with intact cognition, those with moderate or severe cognitive impairment were less likely to belong to the fatigue subgroup [aOR(95% CI): moderate: 0.75 (0.71-0.80); severe: 0.26 (0.23-0.29)] and more likely to belong to the depressed mood subgroup [aOR (95% CI): moderate: 4.54 (3.55-5.81); severe: 6.41 (4.86-8.44)]. Residents with moderate cognitive impairment had increased odds [aOR (95% CI): 1.19 (1.12-1.27)] while those with severe impairment had reduced odds of being in the multiple symptoms subgroup [aOR (95% CI): 0.63 (0.58-0.68)]. CONCLUSIONS: Findings provide a basis for improving depression management with consideration of both subgroups of depression symptoms and levels of cognitive function.Source
Yuan Y, Min HS, Lapane KL, Rothschild AJ, Ulbricht CM. Depression symptoms and cognitive impairment in older nursing home residents in the USA: A latent class analysis. Int J Geriatr Psychiatry. 2020 Apr 6. doi: 10.1002/gps.5301. Epub ahead of print. PMID: 32250496. Link to article on publisher's site
DOI
10.1002/gps.5301Permanent Link to this Item
http://hdl.handle.net/20.500.14038/46875PubMed ID
32250496Related Resources
ae974a485f413a2113503eed53cd6c53
10.1002/gps.5301