Depression in older surgical patients: a multicentre prospective longitudinal study

Area of Science:

• Geriatric Medicine
• Surgical Outcomes
• Mental Health Research

Background:

• Longitudinal studies on postoperative depression are crucial for risk assessment in older adults.
• Understanding the prevalence and trajectory of depression in this demographic is essential.

Purpose of the Study:

• To explore the prevalence and trajectory of depression in older surgical patients.
• To identify associated risk factors and clinical outcomes.
• To examine depression at multiple time points: pre-surgery, and 30, 90, and 180 days post-surgery.

Main Methods:

• A prospective cohort study involving 307 surgical patients aged 65 years and older.
• Online surveys administered pre- and post-surgery to assess depression using the 15-item Geriatric Depression Scale (≥5 cut-off).
• Assessment of risk factors, clinical outcomes, and patient-centered outcomes related to depression.

Main Results:

• Preoperative depression was identified in 20.2% of participants; 17.6% had potentially unrecognized depression.
• At 180 days post-surgery, 18.7% of patients reported depression.
• Preoperative cognitive impairment (OR: 2.91) and sleep disturbances (OR: 2.91) tripled the odds of preoperative depression.
• Preoperative functional disability increased the odds of preoperative depression four-fold (OR: 4.15) and depression at 180 days six-fold (OR: 5.91).
• Patients with depression had 2.5-fold higher odds of non-home discharge (OR: 2.40).

Conclusions:

• The prevalence of depression remained significant, with 20.2% pre-surgery and 18.7% at 180 days post-surgery.
• Mental health is closely linked to functional status, cognitive function, and sleep quality in older surgical patients.