Indicators of a new depression diagnosis in nursing home residents.

Depression affects approximately 30% to 40% of nursing home residents but frequently goes unrecognized. Using the Missouri Minimum Data Set, we aimed to determine whether changes in clinical status, other than mood changes, were associated with new depression diagnosis in residents 65 and older without a recorded depression diagnosis. Of 127,587 potential participants, 14,371 met inclusion criteria and were not depressed at baseline (Time 0). At the next quarterly assessment (Time 1), 1,342 (9.3%) had acquired a new diagnosis of depression. Residents with new depression were significantly younger and less cognitively impaired. Nearly 30% had a decline in activities of daily living (ADL) performance. The multivariate model predicting depression showed that increased verbal aggression, urinary incontinence, increased pain, weight loss, change in care needs, cognitive decline, and ADL decline significantly increased the likelihood of new depression diagnosis. The pattern of decline identified here may provide additional clues to the presence of underlying depression.