Anxiety and depression among nursing home residents without cognitive impairment

Abstract

Background: Anxiety and depression symptoms and their association with components of social support have been studied rarely among nursing home residents without cognitive impairment.

Aim: To investigate the prevalence of the diagnosis and symptoms of depression and anxiety and their combination, the use of antidepressant and anxiolytic drugs in nursing home residents without cognitive impairment and how attachment, nurturance, reassurance of worth and social integration are associated with anxiety and depression symptom scores.

Method: A cross-sectional observation study of 227 residents 65-102 years old with ≥6 months'; residence in 30 nursing homes. All had a Clinical Dementia Rating ≤0.5 and could converse. The Hospital Anxiety and Depression Scale and Social Provision Scale were used in face-to-face interviews. Sociodemographic variables, medical diagnoses and drug information were obtained from medical records. Pearson's chi-squared test and ordinal logistic regression were used to identify associations between anxiety and depression and the Social Provision Scale.

Results: Twice as many residents had symptoms of depression (n = 72, 32%), anxiety (n = 33, 14%) and both (n = 22, 10%) as the respective diagnoses in their medical records (depression diagnosis, n = 40, 18%; anxiety, n = 20, 9%; both, n = 12, 5%). Nevertheless, more were treated with antidepressant and anxiolytic drugs than having the respective diagnosis. The social support subdimensions reassurance of worth and social integration were correlated with less depressive symptoms. Attachment was correlated with less anxiety.

Conclusion: Anxiety and depression symptoms were common and often not diagnosed. Attachment was associated with less anxiety and reassurance of worth and social integration with less depression. Nursing staff should give support to improve attachment, reassurance of worth and social integration and closely observe residents without cognitive impairment for symptoms of anxiety and depression.

Keywords: anxiety; depression; nursing home; older; social support.