Older people with hip fracture: depression in the postoperative first year

This paper is a report of a study conducted to describe changes in risk of depressive symptoms and their predictors for older people with hip fracture during the first year following hospital discharge.

The prevalence of depression in older people with hip fracture has been reported as 9-47%. However, the longitudinal changes in prevalence rate following hip fracture have not been well-studied, particularly in Asian countries.

The study was conducted in Taiwan in 2001-2003. A sample of 147 older people with hip fracture was assessed for depressive symptoms before discharge, and at 1, 3, 6 and 12 months after discharge using the Chinese version of the Geriatric Depression Scale. Longitudinal data were analysed by the generalized estimating equation approach. Findings. The majority of participants were at risk for depressive symptoms before discharge (n = 147, 57.8%) and 35.6% (n = 118) 12 months after discharge. These numbers decreased statistically significantly from before discharge to the 1st month after discharge (57.8% vs. 42.6%, P = 0.008), and from the 1st to the 6th month (42.6% vs. 31.3%, P = 0.03), and then remained stable until the 12th month after discharge. Lower emotional-social support predicted persistent depressive symptoms after discharge (P < 0.01).

Timely psychological interventions are suggested within the first 6 months after discharge, especially the first 3 months. Healthcare professionals need to pay attention to older patients with hip fracture who are female, with poorer prefracture functioning and particularly those with lower emotional-social support.