方法
這個研究主要在檢視 (1) 憂鬱症對高齡住院病人在他們出院時，在臨床上的表徵、生活品質的進步程度以及功能性的進步有何重要影響 (2) 還有那些因素會影響到出院時的生活品質。從2009年到2010年，總共有471個住院到高齡病房的病人參與這個研究。研究的工具使用周全性老年評估包含了日常生活活動功能評估（Activities of daily living; ADL）、老年憂鬱症量表（Geriatric depression scale; GDS）以及簡易智能量表（Mini-mental state examination; MMSE）。生活品質在病人出院時進行測量，採用European Quality of Life-5 Dimensions與European Quality of Life-5 Dimensions Visual Analog Scale 作為評估工具。病人住院的天數與Charlson comorbidity index 則是使用病歷回顧的方式進行記錄。統計方式包含了Chi-square test、independent t-test、Mann-Whitney U test與multiple linear regression。
結論
在高齡的住院病人中，我們不能忽視憂鬱症的存在，因為憂鬱症會造成生活品質的下降與併發症。我們應該更重視高齡住院病人可能的憂鬱症狀，並及早介入。除此之外，憂鬱症的介入不應只是在短期的住院治療中，因為憂鬱症可能延續到急性出院後。著眼於長期照顧體系的發展，更應該採用周全的評估方式，及早發現與治療老年期憂鬱症。
Background
Late-life depression is common among elderly patients. Ignorance of the health problem, either because of under-diagnosis or under-treatment, causes additional medical cost and comorbidity. For a better health and quality of life (QoL), evaluation, prevention and treatment of late-life depression in elderly patients is essential.
Methods
This study examined (1) the differences of clinical characteristics, degree of improvement on QoL and functionality on discharge between non-depressed and depressed elderly inpatients, and (2) factors associated with QoL on discharge. Four hundred and seventy one elderly inpatients admitted to a geriatric evaluation and management unit (GEMU) from 2009 to 2010 were enrolled in this study. Comprehensive geriatric assessments including the activities of daily living (ADL), geriatric depression scale, and mini-mental state examination were conducted. QoL was assessed using the European Quality of Life-5 Dimensions and the European Quality of Life-5 Dimensions Visual Analog Scale on discharge. Information on hospital stay and Charlson comorbidity index were obtained by chart review. Chi-square tests, independent t-tests, Mann-Whitney U tests and multiple linear regressions were used in statistical analysis.
Results
Worse QoL and ADL on discharge were found among the depressed. Depressive symptoms, female gender, duration of hospital stay, and rehabilitation were significant factors affecting QoL on discharge in linear regression models.
Conclusions
The importance of diagnosis and treatment of depression among elderly inpatients should not be overlooked during hospital stay and after discharge. More efforts should be made to improve intervention for depressed elderly inpatients. Besides, we should keep following and helping them after discharge since depressive symptoms could remain for a long period of time. Along with the development of long-term care, more comprehensive assessment and should be applied for early diagnosis and intervention of late life depression.
