A High Geriatric Depression Scale Score on Admission to Hospital Predicts a Worse Clinical Frailty Scale Score After Discharge

AIM: This study aimed to determine whether a higher Geriatric Depression Scale-15 (GDS-15) score on admission is associated with worsening of the Clinical Frailty Scale (CFS) score from discharge to 3 months after discharge in older patients hospitalized for acute care. METHODS: This multicenter prospective study was performed at three university hospitals and one national medical center in Japan between October 2019 and July 2023. A total of 601 patients were analyzed. Post-discharge CFS worsening was defined as a ≥ 1-point increase in CFS score from discharge to 3 months after discharge. Logistic regression, subgroup, sensitivity, and formal interaction analyses were performed. RESULTS: From discharge to 3 months after discharge, the CFS score worsened in 87 patients (14.5%). The worsened group had significantly higher GDS-15 scores on admission (p = 0.047). After adjustment for age, sex, baseline CFS score, CCI value, and MMSE score, a higher GDS-15 score was associated with greater odds of CFS worsening (OR 1.109, p = 0.002). In subgroup analysis, this association was observed in patients with baseline CFS scores ≥ 4 (OR 1.106, p = 0.007), but not in those with baseline CFS scores ≤ 3. The formal interaction test was not significant (p = 0.969). The association remained significant in sensitivity analyses. CONCLUSIONS: A higher GDS-15 score on admission independently predicted post-discharge CFS worsening in older acute-care inpatients. GDS-15 screening on admission may help identify patients requiring closer post-discharge monitoring for frailty deterioration.