Suicidal Ideation After Hip Fracture in Older Adults

A disabling medical event, such as a hip fracture, can cause psychological destabilisation and increase suicide risk. This study aimed to estimate incident suicide ideation (SI) within 1 year after a hip fracture and identify psychosocial predictors of SI and associations with functional recovery.

A secondary analysis was conducted with data from a longitudinal study of risk factors for late-life depression after hip fracture. Four hundred and ninety-four patients with hip fracture and without prior clinical depression, and a comparison sample of 102 healthy community-dwelling older adults, were included in analyses. Participants were interviewed with the Montgomery-Asberg Depression Rating Scale, which includes an item assessing SI at eight timepoints after hip fracture.

SI was endorsed by 14.8% (73) of patients versus 5.9% (6) healthy controls during the year after hip fracture. Suicidal thoughts were commonly passive and transient. Older age (OR = 1.04) and higher perceived stress (OR = 2.07) uniquely predicted SI. Function was associated with SI immediately after the fracture and 6-12 months later.

Findings suggest that there are vulnerable periods for SI after a hip fracture, particularly for people who experience high stress. The relationship between SI and function is strongest 6-12 months after a fracture.