A High Geriatric Depression Scale Score on Admission to Hospital Predicts a Worse Clinical Frailty Scale Score After Discharge
Yosuke Yamada, Hirotaka Nakashima, Masaaki Nagae, Kazuhisa Watanabe, Chisato Fujisawa, Hitoshi Komiya, Tomihiko Tajima, Shosuke Satake, Yasushi Takeya, Yumi Umeda‐Kameyama, Hiroyuki UmegakiABSTRACT
Aim
This study aimed to determine whether a higher Geriatric Depression Scale‐15 (GDS‐15) score on admission is associated with worsening of the Clinical Frailty Scale (CFS) score from discharge to 3 months after discharge in older patients hospitalized for acute care.
Methods
This multicenter prospective study was performed at three university hospitals and one national medical center in Japan between October 2019 and July 2023. A total of 601 patients were analyzed. Post‐discharge CFS worsening was defined as a ≥ 1‐point increase in CFS score from discharge to 3 months after discharge. Logistic regression, subgroup, sensitivity, and formal interaction analyses were performed.
Results
From discharge to 3 months after discharge, the CFS score worsened in 87 patients (14.5%). The worsened group had significantly higher GDS‐15 scores on admission ( p = 0.047). After adjustment for age, sex, baseline CFS score, CCI value, and MMSE score, a higher GDS‐15 score was associated with greater odds of CFS worsening (OR 1.109, p = 0.002). In subgroup analysis, this association was observed in patients with baseline CFS scores ≥ 4 (OR 1.106, p = 0.007), but not in those with baseline CFS scores ≤ 3. The formal interaction test was not significant ( p = 0.969). The association remained significant in sensitivity analyses.
Conclusions
A higher GDS‐15 score on admission independently predicted post‐discharge CFS worsening in older acute‐care inpatients. GDS‐15 screening on admission may help identify patients requiring closer post‐discharge monitoring for frailty deterioration.