Prevalence and prognostic significance of depressive symptoms in a geriatric post-hip fracture assessment

ABSTRACTBackground: The effects of depression and cognitive impairment on hip fracture rehabilitation outcomes are not well established. We aimed to evaluate the associations of depressive symptoms and cognitive impairment (individually and combined) with ambulatory, living activities and quality of life outcomes in hip fracture rehabilitation patients.Methods: A cohort of 146 patients were assessed on depressive symptoms (Geriatric Depression Scale, GDS ≥ 5), cognitive impairment (Mini-mental State Examination, MMSE ≤ 23), and other variables at baseline, and on ambulatory status, Modified Barthel Index (MBI), and SF-12 PCS and MCS quality of life on follow ups at discharge, 6 months and 12 months post fracture.Results: In these patients (mean age 70.8 years, SD 10.8), 7.5% had depressive symptoms alone, 28.8% had cognitive impairment alone, 50% had both, and 13.7% had neither (reference). Ambulatory status showed improvement over time in all mood and cognition groups ((β = 0.008, P = 0.0001). Patients who had cognitive impairment alone (β = −0.060, P = 0.001) and patients who had combined cognitive impairment with depressive symptoms β = −0.62, P = 0.0003), showed significantly less improvement in ambulatory status than reference patients. In the latter group, the relative differences in ambulatory scores from the reference group were disproportionately greater over time (β = −0.003, SE = 0.001, P = 0.021). Patients with combined depressive symptoms and cognitive impairment also showed a significantly lower MBI score, (β = −10.92, SE = 4.01, P = 0.007) and SF-12 MCS (β = −8.35, SE = 2.37, P = 0.0006). Mood and cognition status did not significantly predict mortality during the follow-up.Conclusion: Depression and cognitive impairment comorbidity is common in hip fracture rehabilitation patients and significantly predicts poor functional and quality of life outcomes.

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Depressive symptoms are associated with reduced neutrophil function in hip fracture patients

Brain Behavior and Immunity ◽

10.1016/j.bbi.2013.07.004 ◽

2013 ◽

Vol 33 ◽

pp. 173-182 ◽

Cited By ~ 25

Author(s):

Niharika Arora Duggal ◽

Jane Upton ◽

Anna C. Phillips ◽

Peter Hampson ◽

Janet M. Lord

Keyword(s):

Depressive Symptoms ◽

Hip Fracture ◽

Neutrophil Function

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Prognostic Significance of Depressive Symptoms on Weight Loss and Psychosocial Outcomes Following Gastric Bypass Surgery: A Prospective 24-Month Follow-Up Study

Obesity Surgery ◽

10.1007/s11695-015-1631-9 ◽

2015 ◽

Vol 25 (10) ◽

pp. 1909-1916 ◽

Cited By ~ 44

Author(s):

Marney A. White ◽

Melissa A. Kalarchian ◽

Michele D. Levine ◽

Robin M. Masheb ◽

Marsha D. Marcus ◽

...

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Depressive Symptoms ◽

Bypass Surgery ◽

Gastric Bypass Surgery ◽

Prognostic Significance ◽

Psychosocial Outcomes ◽

Follow Up Study

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Elevated serum cardiac troponin I in older patients with hip fracture: incidence and prognostic significance

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-008-0588-8 ◽

2008 ◽

Vol 128 (7) ◽

pp. 761-762 ◽

Cited By ~ 7

Author(s):

Sylvain Ausset ◽

Vincent Minville ◽

Constance Marquis ◽

Dan Benhamou ◽

Sylvan Rigal

Keyword(s):

Hip Fracture ◽

Cardiac Troponin ◽

Older Patients ◽

Troponin I ◽

Prognostic Significance ◽

Elevated Serum ◽

Cardiac Troponin I ◽

Fracture Incidence ◽

Hip Fracture Incidence ◽

Serum Cardiac Troponin

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Prognostic factors of depression and depressive symptoms after hip fracture surgery: systematic review

BMC Geriatrics ◽

10.1186/s12877-021-02514-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

R. Milton-Cole ◽

S. Ayis ◽

K. Lambe ◽

M. D. L. O’Connell ◽

C. Sackley ◽

...

Keyword(s):

Prognostic Factors ◽

Depressive Symptoms ◽

Hip Fracture ◽

Data Extraction ◽

High Quality Research ◽

Hip Fracture Surgery ◽

Modelling Studies ◽

Underlying Mechanisms ◽

Fracture Surgery

Abstract Background Patients with hip fracture and depression are less likely to recover functional ability. This review sought to identify prognostic factors of depression or depressive symptoms up to 1 year after hip fracture surgery in adults. This review also sought to describe proposed underlying mechanisms for their association with depression or depressive symptoms. Methods We searched for published (MEDLINE, Embase, PsychInfo, CINAHL and Web of Science Core Collection) and unpublished (OpenGrey, Greynet, BASE, conference proceedings) studies. We did not impose any date, geographical, or language limitations. Screening (Covidence), extraction (Checklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies, adapted for use with prognostic factors studies Checklist), and quality appraisal (Quality in Prognosis Studies tool) were completed in duplicate. Results were summarised narratively. Results In total, 37 prognostic factors were identified from 12 studies included in this review. The quality of the underlying evidence was poor, with all studies at high risk of bias in at least one domain. Most factors did not have a proposed mechanism for the association. Where factors were investigated by more than one study, the evidence was often conflicting. Conclusion Due to conflicting and low quality of available evidence it is not possible to make clinical recommendations based on factors prognostic of depression or depressive symptoms after hip fracture. Further high-quality research investigating prognostic factors is warranted to inform future intervention and/or stratified approaches to care after hip fracture. Trial registration Prospero registration: CRD42019138690.

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Effects of Prefracture Depressive Illness and Postfracture Depressive Symptoms on Physical Performance After Hip Fracture

Journal of the American Geriatrics Society ◽

10.1111/jgs.14487 ◽

2016 ◽

Vol 64 (11) ◽

pp. e171-e176 ◽

Cited By ~ 6

Author(s):

Alan M. Rathbun ◽

Michelle Shardell ◽

Denise Orwig ◽

Ann L. Gruber-Baldini ◽

Glenn Ostir ◽

...

Keyword(s):

Depressive Symptoms ◽

Hip Fracture ◽

Physical Performance ◽

Depressive Illness

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Trajectories of depressive symptoms after hip fracture

Psychological Medicine ◽

10.1017/s0033291715002974 ◽

2016 ◽

Vol 46 (7) ◽

pp. 1413-1425 ◽

Cited By ~ 20

Author(s):

P. Cristancho ◽

E. J. Lenze ◽

M. S. Avidan ◽

K. S. Rawson

Keyword(s):

Depressive Symptoms ◽

Hip Fracture ◽

Functional Recovery ◽

Functional Outcomes ◽

Stressful Life Events ◽

Rating Scale ◽

Fracture Repair ◽

Walking Ability ◽

Psychosocial Variables ◽

Antidepressant Use

BackgroundHip fracture is often complicated by depressive symptoms in older adults. We sought to characterize trajectories of depressive symptoms arising after hip fracture and examine their relationship with functional outcomes and walking ability. We also investigated clinical and psychosocial predictors of these trajectories.MethodWe enrolled 482 inpatients, aged ⩾60 years, who were admitted for hip fracture repair at eight St Louis, MO area hospitals between 2008 and 2012. Participants with current depression diagnosis and/or notable cognitive impairment were excluded. Depressive symptoms and functional recovery were assessed with the Montgomery–Asberg Depression Rating Scale and Functional Recovery Score, respectively, for 52 weeks after fracture. Health, cognitive, and psychosocial variables were gathered at baseline. We modeled depressive symptoms using group-based trajectory analysis and subsequently identified correlates of trajectory group membership.ResultsThree trajectories emerged according to the course of depressive symptoms, which we termed ‘resilient’, ‘distressed’, and ‘depressed’. The depressed trajectory (10% of participants) experienced a persistently high level of depressive symptoms and a slower time to recover mobility than the other trajectory groups. Stressful life events prior to the fracture, current smoking, higher anxiety, less social support, antidepressant use, past depression, and type of implant predicted membership of the depressed trajectory.ConclusionsDepressive symptoms arising after hip fracture are associated with poorer functional status. Clinical and psychosocial variables predicted membership of the depression trajectory. Early identification and intervention of patients in a depressive trajectory may improve functional outcomes after hip fracture.

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Troponin T in Hip Fracture Patients: Prognostic Significance for Mortality at One Year

Hip International ◽

10.5301/hip.2011.8840 ◽

2011 ◽

Vol 21 (6) ◽

pp. 757-761 ◽

Cited By ~ 10

Author(s):

Edward Spurrier ◽

David Wordsworth ◽

Steven Martin ◽

Rory Norris ◽

Martyn J. Parker

Keyword(s):

Hip Fracture ◽

Troponin T ◽

Prognostic Significance ◽

The Elderly ◽

Cardiac Complications ◽

Mortality And Morbidity ◽

The Mean ◽

One Year ◽

Acute Cardiac Event ◽

Significant Mortality

Hip fractures are common injuries in the elderly, with significant mortality and morbidity from several factors. Many of these patients have cardiac disease, and some develop cardiac complications which may increase mortality. Troponin T is a marker of myocardial injury but can be raised in other conditions. Patients over 60 years admitted with hip fracture during the study period had their troponin T measured on admission and postoperatively. Assay was performed after the patient had completed their treatment. We report the results of this study one year after the last patient was admitted. 108 patients were recruited. The average age was 84 years, 86% were female. The mean hospital stay was 20 days. This study found that 27% of hip fracture patients had some increase in the troponin T levels in the peri-operative period. This increase was not associated with an increase in early mortality, but there was an increase in one-year mortality for those with an increase in troponin T (45% versus 22%, p=0.03). These findings indicate that the routine measurement of troponin T does not correlate with acute mortality and is not necessary without evidence of an acute cardiac event.

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