Moderate to severe depressive symptoms and rehabilitation outcome in older adults with hip fracture

Sara Morghen, Giuseppe Bellelli, Sara Manuele, Fabio Guerini, Giovanni B. Frisoni, Marco Trabucchi

Research output: Contribution to journalArticlepeer-review

Abstract

Objective 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. Methods 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 a 12/15 at the BI walking sub-item. Results 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, ORa;circcirc 95% CIΣ1.3 to 7.8; pΣ0.010) and to be institutionalized or died at 1 year (ORΣ3.6, 95% CIΣ1.4 to 9.1, pΣ0.007). 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. Conclusions Moderate to severe depressive symptoms affect the recovery of walking independence after HF rehabilitation and are associated with severe adverse outcomes at 1 year.

Original languageEnglish
Pages (from-to)1136-1143
Number of pages8
JournalInternational Journal of Geriatric Psychiatry
Volume26
Issue number11
DOIs
Publication statusPublished - Nov 2011

Keywords

  • depression
  • functional recovery
  • hip fracture
  • mortality
  • rehabilitation

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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