Using the Hospital Anxiety and Depression Scale in Patients 80 Years‐Old and Older: A Systematic Review

Abstract

AimsTo identify and report results from studies of anxiety and depression, as measured by The Hospital Anxiety and Depression Scale (HADS) in patients ≥ 80 years admitted to hospital settings, and to inform nurses, researchers and educators in nursing about these findings.DesignSystematic review.Data SourcesMEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane, Epistemonikos, Scopus and Web of Science Core Collection of studies published until October 2023.MethodsA search strategy was developed with a university librarian. Four independent reviewers screened titles and abstracts based on predefined inclusion criteria. Data were systematically extracted, descriptively analysed, and Critical Appraisal Skills Programme checklists were used to assess studies.ResultsOut of 7076 identified studies, three met the eligibility criteria. Data from 420 participants aged ≥ 80 years were analysed, revealing anxiety prevalence rates between 6% and 18% and mean scores below 4. Depression prevalence rates ranged from 7% to 17%, with a mean score below 4. Most patients with depression were not previously recognised as being depressed.ConclusionsFew publications reported on anxiety and/or depression in hospitalised patients aged ≥ 80 years using HADS. A gap in the knowledge base has been identified.ImplicationsAnxiety and depression are mental health conditions that can lead to adverse events and strongly affect aging. Increased understanding of the role that these conditions have on hospitalised patients ≥ 80 years is important for nurses when in contact with this patient group.ImpactThere is a need for more studies to generate evidence regarding anxiety and depression in an increasingly common and challenging hospital population by building upon evidence that is based on validated instruments such as the Hospital Anxiety and Depression Scale.Reporting MethodThe PRISMA guideline was followed, and the review registered in PROSPERO (Registration number CRD 42022380943).Patient ContributionNo patient or public contribution.Trial RegistrationCRD 42022380943