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Functional recovery after hip fracture: the combined effects of depressive symptoms, cognitive impairment, and delirium.
J Am Geriatr Soc 2008; 56(6):1075-9JA

Abstract

OBJECTIVES

To measure the prevalence of depressive symptoms, cognitive impairment, and delirium in patients with hip fracture and to estimate their effect on functional recovery, institutionalization, and death after surgical repair.

DESIGN

Prospective cohort.

SETTING

Hospital, follow-up to community and nursing home.

PARTICIPANTS

One hundred twenty-six patients aged 65 and older admitted for hip fracture repair.

MEASUREMENTS

Baseline measurements: Mini-Mental State Examination, Blessed Dementia Rating Scale, Geriatric Depression Scale, prefracture activities of daily living (ADLs), ambulatory status. The Confusion Assessment Method was used to diagnose in-hospital delirium. One- and 6-month outcomes were ADL decline, loss of ambulation, and new nursing home placement or death.

RESULTS

Twenty-two percent of patients had one cognitive or mood disorder, 30% had two, and 7% had three. At 1 month, each cognitive or mood disorder was independently associated with one or more adverse outcome. Considered together, each additional cognitive or mood disorder was associated with greater odds of 1 month outcomes (ADL decline: odds ratio (OR)=1.8, 95% confidence interval (CI)=1.1-2.9; decline in ambulation: OR=1.8, 95% CI=1.1-3.0; nursing home placement or death: OR=3.9, 95% CI=1.9-8.1).

CONCLUSION

Cognitive and mood disorders were common in elderly hip fracture patients and were associated with greater risk of poor outcomes, both independently and in combination. Recognition and treatment of these conditions may reduce adverse outcomes in this vulnerable population.

Authors+Show Affiliations

Geriatrics Section, Boston University Medical Center, Boston, Massachusetts 02118, USA. jane.givens@bmc.orgNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18422945

Citation

Givens, Jane L., et al. "Functional Recovery After Hip Fracture: the Combined Effects of Depressive Symptoms, Cognitive Impairment, and Delirium." Journal of the American Geriatrics Society, vol. 56, no. 6, 2008, pp. 1075-9.
Givens JL, Sanft TB, Marcantonio ER. Functional recovery after hip fracture: the combined effects of depressive symptoms, cognitive impairment, and delirium. J Am Geriatr Soc. 2008;56(6):1075-9.
Givens, J. L., Sanft, T. B., & Marcantonio, E. R. (2008). Functional recovery after hip fracture: the combined effects of depressive symptoms, cognitive impairment, and delirium. Journal of the American Geriatrics Society, 56(6), pp. 1075-9. doi:10.1111/j.1532-5415.2008.01711.x.
Givens JL, Sanft TB, Marcantonio ER. Functional Recovery After Hip Fracture: the Combined Effects of Depressive Symptoms, Cognitive Impairment, and Delirium. J Am Geriatr Soc. 2008;56(6):1075-9. PubMed PMID: 18422945.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Functional recovery after hip fracture: the combined effects of depressive symptoms, cognitive impairment, and delirium. AU - Givens,Jane L, AU - Sanft,Tara B, AU - Marcantonio,Edward R, Y1 - 2008/04/18/ PY - 2008/4/22/pubmed PY - 2008/7/9/medline PY - 2008/4/22/entrez SP - 1075 EP - 9 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 56 IS - 6 N2 - OBJECTIVES: To measure the prevalence of depressive symptoms, cognitive impairment, and delirium in patients with hip fracture and to estimate their effect on functional recovery, institutionalization, and death after surgical repair. DESIGN: Prospective cohort. SETTING: Hospital, follow-up to community and nursing home. PARTICIPANTS: One hundred twenty-six patients aged 65 and older admitted for hip fracture repair. MEASUREMENTS: Baseline measurements: Mini-Mental State Examination, Blessed Dementia Rating Scale, Geriatric Depression Scale, prefracture activities of daily living (ADLs), ambulatory status. The Confusion Assessment Method was used to diagnose in-hospital delirium. One- and 6-month outcomes were ADL decline, loss of ambulation, and new nursing home placement or death. RESULTS: Twenty-two percent of patients had one cognitive or mood disorder, 30% had two, and 7% had three. At 1 month, each cognitive or mood disorder was independently associated with one or more adverse outcome. Considered together, each additional cognitive or mood disorder was associated with greater odds of 1 month outcomes (ADL decline: odds ratio (OR)=1.8, 95% confidence interval (CI)=1.1-2.9; decline in ambulation: OR=1.8, 95% CI=1.1-3.0; nursing home placement or death: OR=3.9, 95% CI=1.9-8.1). CONCLUSION: Cognitive and mood disorders were common in elderly hip fracture patients and were associated with greater risk of poor outcomes, both independently and in combination. Recognition and treatment of these conditions may reduce adverse outcomes in this vulnerable population. SN - 1532-5415 UR - https://www.unboundmedicine.com/medline/citation/18422945/Functional_recovery_after_hip_fracture:_the_combined_effects_of_depressive_symptoms_cognitive_impairment_and_delirium_ L2 - https://doi.org/10.1111/j.1532-5415.2008.01711.x DB - PRIME DP - Unbound Medicine ER -