Biopsychosocial factors related to depression in aged care residents

Background: While depression is common in residential aged care settings, there is an absence of research into factors that may be associated with this condition. This pilot study examined the relationship between depression and multiple biopsychosocial factors among residents of aged care facilities. Methods: Participants were 50 aged care residents with a diagnosis of major depressive disorder, based on a clinical assessment using the SCID-I, and a matched sample of 50 residents without depression. The sample consisted of 80 women and 20 men without significant cognitive impairment, with a mean age of 83.0 years (SD=7.2 years). Participants completed a diagnostic interview with a clinical psychologist to determine the presence or absence of a mood disorder, and a set of scales related to demographics, depressive symptoms, physical health, functional disability, religiosity, and psychological wellbeing. Results: The unique predictors of scores on the Geriatric Depression Scale-15 were environmental mastery, purpose in life, and autonomy. These three variables discriminated between participants with and without a diagnosis of MDD with 80% accuracy. Limitations: Findings were limited by the cross-sectional methodology and small sample size of cognitively intact English-speaking aged care residents. Replication is required with a prospective longitudinal design with a broader sample of residents. Conclusions: Psychological variables were more important in understanding depression among aged care residents than traditional risk factors such as medical illness and disability. While preliminary, these findings highlight possible targets to prevent and treat depression in aged care settings. (C) 2012 Elsevier B.V. All rights reserved.