Depressive symptoms in long-term care residents in Taiwan

Aim. This paper reports a study to investigate the prevalence of and risk factors for depressive symptoms in elders in long-term care facilities in Taiwan. Background. Depression has been identified as a major health concern and is very common among frail elders in Western nursing homes. It is under-diagnosed, and may be associated with eating difficulties and subsequent malnutrition, functional ability and sociodemographic factors. There have been no previous studies of these issues in Taiwan. Methods. Residents of 18 long-term care facilities were recruited. Those able to communicate in the Mandarin or Taiwanese dialect, resided in long-term care facilities including skilled nursing facilities and intermediate care facilities, and who scored three or above on the Short Portable Mental Status Questionnaire were selected. Data were collected using the Geriatric Depression Scale, Barthel Index and Masticatory Index, and age, duration of institutionalization, and level of impaired swallowing were also measured. Results. The number of participants identified as depressed was 267 (52.05%). There was no significant difference noted relating to age, gender, duration of institutionalization, type of institution, mental status and masticatory ability between the depressed and non-depressed groups, but significant differences of functional status and impaired swallowing between the two groups were found. However, functional status, impaired swallowing, and type of institution were three independent factors associated with depressive symptoms after controlling for all other factors. Conclusions. Future studies on the detection of symptoms of depression should use a validated observational measure to overcome under-reporting of symptoms by the frailest residents.