Date of Award

12-16-2013

Document Type

Open Access Dissertation

Department

Health Services and Policy Management

First Advisor

Janice C Probst

Abstract

BACKGROUND: The purpose of this study was to explore both positive screened MDD and the perception of being depressed (P) and the likelihood of either increasing if the patient suffered from arthritis (P/E), either perceived or evaluated by a physician. The study explored the univariate, bivariate, and multivariate relationships between MDD and depression (P) to better describe influencing characteristics and their prevalence, as related to MDD and depression (P).

METHODS: The study examined a cross section of patients 65 years and older (n=8,205) within the National Epidemiologic Survey on Alcohol Abuse and Alcoholism (NESARC) [2001-02] sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). A multivariate analysis was conducted using SAS Callable SUDAAN to account for the complex design of the study and adjusted odds ratios (ORs) of modeling were computed to account for Models 1-4.

RESULTS: Those persons age 65 and older who report having arthritis (P/E) were significantly more likely to be suffering from MDD than those who have not reported having an arthritic condition (P/E) [results were positive within Models 2-4]. Those persons age 65 and older who report having arthritis (P/E) were not significantly more likely to be suffering from depression (P) than those who have not reported having an arthritic condition (P/E) [results were negative within Models 2-4].

This creates significant concern, given that each of the multivariate models (2-4) examined arthritis (P/E) while utilizing the same control variables throughout. Further, many of the relationally significant variables in the MDD versus depression (P) models were not the same (Table 4.4 /4.5).

CONCLUSION: This study demonstrated a significant difference within the senior population between those with arthritis (P/E) and those who have positively screened MDD and depression (P). Seniors with arthritis (P/E) seem to respond differently with regards to positively screened MDD and depression (P). The results demonstrated conclusive evidence that one cannot count on an elderly patient to have a positive perception of depression as it relates to being positively screened for MDD. Further, it would appear that older persons may not disclose whether or not they are depressed in a clinical environment. This becomes important to clinicians and further demonstrated the need for clinically valid assessment measures to ensure preventative measures are being taken to address elderly depression.

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