Social functioning, polypharmacy and depression in older Chinese primary care patients.

Objective: This study aims to identify the relationship among social functioning, polypharmacy and depression among older patients in Hong Kong.

Method: Three out of 18 elderly health centres were selected using the cluster sampling method. 457 elders were randomly selected from all the patients aged 65 and over attending the centres, and were interviewed using the Chinese Minimum Data Set-Home Care in 1999. Of them 318 were re-assessed in 2000.

Results: At follow-up, their mean age was 73.6 (SD = 5.5), of whom 51.6% were females. Besides negative emotions, respondents' increased depressive symptoms were associated with using more than four medications and decline in social functioning over time, and behavioural agitation at baseline. If there was no medication review at baseline, the impact of polypharmacy on depression was subsided.

Conclusion: Medication review is important in the prediction and treatment process of depression as it can moderate the impact of social functioning and polypharmacy. Therefore, medical professionals should prescribe fewer medications to eliminate adverse drug reactions and reduce depressive symptoms. However, the study reflects that older adults might feel depressed by not being able to control the result of their reviews. Thus, if the review could involve older patients, it might be more assuring and helps to restore their hope for gaining control in their treatment process.