Symptoms of depression and risk of emergency department visits among people aged 70 years and over
-
Published:2024-02-05
Issue:1
Volume:24
Page:
-
ISSN:1471-2458
-
Container-title:BMC Public Health
-
language:en
-
Short-container-title:BMC Public Health
Author:
Dwyer Rosamond,Jachno Kim,Tran Thach,Owen Alice,Layton Natasha,Collyer Taya,Kirkman Maggie,Lowthian Judy,Hammarberg Karin,McNeil John J.,Woods Robyn L.,Berk Michael,Fisher Jane
Abstract
Abstract
Background
Older people experiencing depression and anxiety have higher rates of health service utilisation than others, but little is known about whether these influence their seeking of emergency care. The aim was to examine the associations between symptoms of depression and the use of emergency health care, in an Australian context, among a population of people aged 70 years and over initially free of cardiovascular disease, dementia or major physical disability.
Methods
We undertook secondary analyses of data from a large cohort of community-dwelling Australians aged $$ \ge $$70 years. Multivariable logistic regression was used to compare the association of symptoms of depression (measured using the Center for Epidemiological Studies Depression Scale 10 question version, CESD at baseline) with subsequent episodes of emergency care, adjusting for physical and social factors of clinical interest. Marginal adjusted odds ratios were calculated from the logistic regression.
Results
Data were available for 10,837 Australian participants aged at least 70 years. In a follow-up assessment three years after the baseline assessment, 17.6% of people self-reported an episode of emergency care (attended an ED of called an emergency ambulance) in the last 12 months. Use of emergency healthcare was similar for men and women (17.8% vs. 17.4% p = 0.61). A score above the cut-off on the CESD at baseline was associated with greater use of emergency health care (OR = 1.35, 95% CI 1.11,1.64). When modelled separately, there was a greater association between a score above the cut-off on the CESD and emergency healthcare for women compared with men.
Conclusions
This study is unique in demonstrating how depressive symptoms among healthy older persons are associated with subsequent increased use of emergency healthcare. Improved understanding and monitoring of mental health in primary care is essential to undertake effective healthcare planning including prevention of needing emergency care.
Funder
National Centre for Healthy Ageing Living Labs Program
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference36 articles.
1. United Nations Department of Economic and Social Affairs Population Division. World Population Ageing 2015. New York. 2015. Contract No.: (ST/ESA/SER.A/390).
2. Australian Bureau of Statistics, Projections P. Australia, 2017 (base)– 2066, cat no. 3222.0 Canberra2018 [Available from: http://www.abs.gov.au/ausstats/abs@.nsf/Latestproducts/3222.0-Main%20Features32017%20(base)%20-%202066?opendocument&tabname=Summary&prodno=3222.0&issue=2017%20(base)%20-%202066&num=&view=.
3. Lowthian J, Curtis A, Stoelwinder PC, Cooke JU, McNeil M. Systematic review of tends in emergency department attendances: an Australian perspective. Emerg Med J. 2011;28:373–7.
4. Lowthian J, Jolley D, Curtis A, Currell A, Cameron P, Stoelwinder JU, et al. The challenges of population ageing: accelerating demand for emergency ambulance services by older patients, 1995–2015. MJA. 2011;194:574–8.
5. Barker W, Zimmer J, Hall J, Ruff B, Freundlich C, Eggert G. Rates, patterns, causes, and costs of hospitalization of nursing home residents: a population-based study. Am J Public Health. 1994;84(10):1615–20.