Do depressive symptoms on hospital admission impact early functional outcome in elderly patients with hip fracture?

BACKGROUND

Depression is the most common mood disorder in elderly people and one of the most prevalent comorbidities in older people with hip fracture. While several authors have confirmed that depressive symptoms assessed at a later stage after hip fracture impact functional outcome and mortality, the role of depressive symptoms identified at an earlier stage after hip fracture remains understudied. The aim of the present study was to determine if depressive symptoms assessed on hospital admission impact early functional outcome after hip fracture surgery.

METHODS

We studied 112 patients who underwent surgery for hip fracture during a 6-month period. Depressive symptoms were assessed using the 30-item Geriatric Depression Scale on admission to the acute setting. Multidimensional assessment included sociodemographic characteristics, general health status, cognitive status, functional status prior to injury, and perioperative variables. The primary outcome measure was motor Functional Independence Measure at discharge.

RESULTS

Adjusted multivariate regression analysis revealed that the presence of moderate to severe depressive symptoms (Geriatric Depression Scale ≥ 20), older age, and female gender were independently related to motor Functional Independence Measure at discharge.

CONCLUSION

Increasing levels of depressive symptoms in elderly hip fracture patients influence short-term functional outcome. We strongly support the introduction of routine assessment of this baseline comorbidity, especially in female patients. Failure to identify such patients is a missed opportunity for possible improvement of early functional outcome after hip fracture in elderly.