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Because of the prevalence of depression in nursing home residents, it’s essential that nursing home workers be able to identify early indicators of depression before mood-related symptoms arise, according to a new study published in The Journal of Gerontological Nursing.

Researchers from the University of Missouri found that some elderly patients exhibit additional clinical changes as their depression develops. Early identification of these characteristics can lead to quicker treatment and improved results. Early indicators include increased verbal aggression, urinary incontinence, increased pain, weight loss, lowered cognitive ability or a decline in performing daily activities.

The researchers also found that patients with increased verbal aggression were 69% more likely to be diagnosed with depression. The MU scientists arrived at these conclusions after studying 14,000 nursing home residents over the age of 65, who were not diagnosed with depression when they entered the study. Depression affects 30% to 40% of all nursing home residents, according to the American Geriatrics Society. Left untreated, depression can lower a resident’s quality of life and even result in suicide.