Depression and Poor Functional Results in Elder Patients with Hip Fracture

Razvan Cosmin Tudor, Nicola Vendemmia, Mihaela Pertea, Viola Badulescu, Aurel Nechita, Anamaria Ciubara

Abstract


Depression is the most common psychiatric disorder in the elderly, as well as one of the most common comorbidities in patients with hip fracture. Although many authors have confirmed that clinically recognized depressive symptomatology after hip fracture has a negative impact on functional outcomes and mortality, the role of depressive symptomatology evaluated at the time of admission remains insufficiently investigated. Depression can be assessed using the Geriatric Depression Scale. Predictor measurements of rehabilitation results that can interact with depression can be obtained. Linear multiple regression modeling can be used to evaluate the relationship between depression and functional outcome. The identified factors associated with the postoperative 1 and 2 year follow-up of a hip fracture should be incorporated into clinical strategies and postoperative nursing to provide muscle rehabilitation and good functional outcomes. In addition, the health care plan must ensure, before discharge, that the community in which older adults live provides nutritional education, cognitive screening and psychological support. Depression is a common disorder among orthopedic patients. A previous psychiatric diagnosis predisposes patients to depression following a trauma. The socio-economic status is also a predictive factor for increasing depression scores at 9 months after discharge. Patients with a greater sense of support from friends and family have an inverse correlation with depression. Reestablishing the quality of life the patient had before the fracture also seems to have a protective effect against depression. The severity of the trauma does not seem to affect the scores for the evaluation of depression. Psychiatric counseling can avoid associated psychiatric comorbidities in trauma patients. High levels of depressive symptomatology in elderly patients with hip fracture influence functional outcomes both in the short and the long term. We firmly support the introduction of the routine evaluation of this comorbidity. Failure to identify this associated pathology in patients with hip fracture represents a missed opportunity for eventual improvement in both early and late functional outcomes.


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