Depression and Risk of Nursing Home Admission Among Older Adults in Home Care in Europe: Results From the Aged in Home Care (AdHOC) Study.

Objective: Depression is a frequent condition observed among nursing home residents. However, so far, limited data are available on the impact of depression on nursing home admission. The aim of the present study was to assess the effect of depression on the risk of nursing home admission in a group of older adults receiving home care in Europe.

Method: We conducted a longitudinal analysis using data from the Aged in Home Care (AdHOC) database, which contains information on older adults receiving home care services in 11 European countries. Subjects had been admitted to the home care programs between 2001 and 2003. Depression was diagnosed as a score >= 3 on the Minimum Data Set (MDS) Depression Rating Scale. Information on nursing home admission was collected semiannually for 1 year by trained research personnel.

Results: The mean age of 2718 older adults entering the study was 82.4 (SD = 7.3) years, 2047 (75.3%) were women, and 331 (12.2%) were depressed. Overall, 49/331 depressed participants (14.8%) and 252/2387 nondepressed participants (10.6%) were admitted to a nursing home (p = .02). After adjusting for potential confounders, the risk of nursing home admission was significantly higher for depressed participants (hazard ratio = 1.43, 95% CI = 1.02 to 2.02). The risk of nursing home admission progressively and significantly increased as MDS Depression Rating Scale score increased (signifying more severe depression) (p = .001 for linear trend).

Conclusions: In older adults receiving home care in Europe, depression is associated with an increased risk for nursing home admission. This association increases with severity of depression.