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045Hospitalisation and Surgery: Is Exposure Associated with Increased Subsequent Depressive Symptoms? Evidence from The Irish Longitudinal Study on Ageing (TILDA)

Background: Increasing numbers of older people are undergoing hospitalisation and surgical procedures. While necessary, these exposures may lead to an increase in depressive symptoms. Our objective was to determine whether hospitalisation or hospitalisation with surgery under general anaesthesia is associated with an increase in depressive symptoms in adults over the age of 50. Methods: Depressive symptoms were assessed using the Centre for Epidemiologic Studies Depression Scale (CES-D) in 8,036 individuals at waves 1 and 2 of The Irish Longitudinal Study on Ageing (TILDA), two years apart. Mixed-effects models were used to investigate the hypothesis after adjustment for risk factors for depression and potential confounders. Results: During the 12 months preceding wave 1, 459 participants were hospitalised (mean age 67.0, 55.3% female) and a further 548 participants (mean age 64.6, 51.8% female) were hospitalised and underwent surgery with general anaesthesia; 6,891 (mean age 63.5, 54.3% female) were not hospitalised. There was a 7% increased adjusted incidence rate of depressive symptoms (IRR [95%CI] = 1.07 [1.02, 1.11]) in the CES-D in the hospitalisation group and a 4% increased adjusted incidence rate of depressive symptoms (IRR [95%CI] = 1.04 [1.00, 1.08]) in the surgery group compared to those with no hospitalisation. Conclusion: Hospitalisation and surgery are associated with increased depressive symptoms. This is the first time a longitudinal population-representative study has demonstrated this relationship for both exposures simultaneously.