Moderate to severe depressive symptoms and rehabilitation outcome in older adults with hip fracture
Article first published online: 9 NOV 2010
Copyright © 2010 John Wiley & Sons, Ltd.
International Journal of Geriatric Psychiatry
Volume 26, Issue 11, pages 1136–1143, November 2011
How to Cite
Morghen, S., Bellelli, G., Manuele, S., Guerini, F., Frisoni, G. B. and Trabucchi, M. (2011), Moderate to severe depressive symptoms and rehabilitation outcome in older adults with hip fracture. Int. J. Geriat. Psychiatry, 26: 1136–1143. doi: 10.1002/gps.2651
- Issue published online: 17 OCT 2011
- Article first published online: 9 NOV 2010
- Manuscript Accepted: 20 SEP 2010
- Manuscript Received: 11 MAY 2010
- hip fracture;
- functional recovery;
To evaluate if depressive symptoms affect recovery of walking ability and 1-year institutionalization or mortality in older adults who underwent post-hip fracture (HF) surgery rehabilitation.
Depressive symptoms were assessed on admission using the 15-item Geriatric Depression Scale (GDS), with scores ≥10/15 indicating moderate to severe depressive symptoms. Multidimensional assessment included Mini Mental State Examination, Charlson Comorbidity Index, Body Mass Index, albumin serum levels, number of drugs, antidepressants and Barthel Index (BI) on admission and at discharge. Walking ability was evaluated using the BI walking sub-item referred to 1 month before HF, on admission, and at discharge. Patients scoring ≤3/15 BI walking sub-item on admission (i.e. those fully dependent or requiring major supervision in walking) were included. Walking independence at discharge was defined as a score ≥12/15 at the BI walking sub-item.
In multivariate analyses, after adjustment for covariates and potential confounders, patients with moderate to severe depressive symptoms were more likely to fail walking independence at discharge (odds ratio, OR = 3.2; 95% CI = 1.3 to 7.8; p = 0.010) and to be institutionalized or died at 1 year (OR = 3.6, 95% CI = 1.4 to 9.1, p = 0.007). In further analyses, the failure to recover walking independence at discharge partly mediates the relationship between moderate to severe depressive symptoms and 1-year adverse events.
Moderate to severe depressive symptoms affect the recovery of walking independence after HF rehabilitation and are associated with severe adverse outcomes at 1 year. Copyright © 2010 John Wiley & Sons, Ltd.