Depression among older adults who developed acute coronary syndrome (ACS) during hospitalization for non-cardiac illness: A prospective observational study.

Abstract

Background: Atypical presentations of ACS delay its recognition and treatment in the older adults. During hospitalization, depression and functional decline, which is unique to older adults, leads to poor clinical outcome. Steps taken for its prevention is unlikely to become a priority for the Cardiologist. This study was conducted to identify depression among older adults who developed ACS during hospitalization for noncardiac illness and their outcome.

Methods: 310 older adults with ACS were included from 26 June 2020 to 13 October 2020. Subjects were divided into those admitted primarily due to an ACS (Group I, n = 94) and those developing ACS after admission for noncardiac illness (Group II, n = 216). Co morbidities, medications, investigations, management, clinical outcome, Geriatric Depression Scale was compared between the two groups at the time of admission, after 30 days and after 6 months.

Results: Majority of them were admitted due to acute kidney injury (27.1%) in group II and had a non ST elevation ACS (90.2%). Optimum management was given to a lesser extent because of the clinical condition of these patients. Depression during hospitalization, during follow up and poor clinical, functional and cognitive outcome was more in group II.

Conclusion: Optimum medical management was not given to considerable number of patients because of atypical presentations, clinical condition, along with functional and cognitive decline which resulted from depression. Clinicians must be vigilant for the development of depression when an older adult is admitted to the hospital, as early detection and optimum management provides better clinical outcome.