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Effect of the overlap syndrome of depressive symptoms and delirium on outcomes in elderly adults with hip fracture: a prospective cohort study.
J Am Geriatr Soc 2014; 62(9):1640-8JA

Abstract

OBJECTIVES

To analyze the incidence of the overlap syndrome of depressive symptoms and delirium, risk factors, and independent and dose-response effect of the overlap syndrome on outcomes in elderly adults with hip fracture.

DESIGN

Prospective cohort study.

SETTING

University hospital.

PARTICIPANTS

Individuals with hip fracture without delirium (N = 277; aged 78.0 ± 8.2) consequently enrolled in a prospective cohort study.

MEASUREMENTS

Depressive symptoms were assessed using the Geriatric Depression Scale and cognitive status using the Short Portable Mental Status Questionnaire upon hospital admission. Incident delirium was assessed daily during the hospital stay using the Confusion Assessment Method. Information on complications acquired in the hospital, severity of complications, re-interventions, length of hospital stay, and 1-month mortality was recorded.

RESULTS

Thirty (10.8%) participants had depressive symptoms alone, 88 (31.8%) delirium alone, 60 (21.7%) overlap syndrome, and 99 (35.7%) neither condition. According to multivariate regression analysis, participants with the overlap syndrome had significantly higher incidence of vision impairment (P = .02), longer time-to-surgery (P = .03), and lower cognitive function (P < .001) than participants with no depressive symptoms and no delirium. In the adjusted regression analysis, participants with neither condition were at lower risk of complications than those with the overlap syndrome (P = .03). After adjustment, participants with the overlap syndrome were at higher risk of longer hospital stay independently (P = .003) and in a dose-response manner in the following order: no depression and no delirium, depressive symptoms alone, delirium alone, and the overlap syndrome (P = .002).

CONCLUSION

Depressive symptoms and delirium increase the likelihood of adverse outcomes after hip fracture in a step-wise manner when they coexist. To reduce the risk of adverse outcome in individuals with hip fracture, efforts to identify, prevent, and treat this condition need to be increased.

Authors+Show Affiliations

Clinic of Anesthesiology, Clinical Centre of Serbia, Belgrade, Serbia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25243678

Citation

Radinovic, Kristina S., et al. "Effect of the Overlap Syndrome of Depressive Symptoms and Delirium On Outcomes in Elderly Adults With Hip Fracture: a Prospective Cohort Study." Journal of the American Geriatrics Society, vol. 62, no. 9, 2014, pp. 1640-8.
Radinovic KS, Markovic-Denic L, Dubljanin-Raspopovic E, et al. Effect of the overlap syndrome of depressive symptoms and delirium on outcomes in elderly adults with hip fracture: a prospective cohort study. J Am Geriatr Soc. 2014;62(9):1640-8.
Radinovic, K. S., Markovic-Denic, L., Dubljanin-Raspopovic, E., Marinkovic, J., Jovanovic, L. B., & Bumbasirevic, V. (2014). Effect of the overlap syndrome of depressive symptoms and delirium on outcomes in elderly adults with hip fracture: a prospective cohort study. Journal of the American Geriatrics Society, 62(9), pp. 1640-8. doi:10.1111/jgs.12992.
Radinovic KS, et al. Effect of the Overlap Syndrome of Depressive Symptoms and Delirium On Outcomes in Elderly Adults With Hip Fracture: a Prospective Cohort Study. J Am Geriatr Soc. 2014;62(9):1640-8. PubMed PMID: 25243678.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of the overlap syndrome of depressive symptoms and delirium on outcomes in elderly adults with hip fracture: a prospective cohort study. AU - Radinovic,Kristina S, AU - Markovic-Denic,Ljiljana, AU - Dubljanin-Raspopovic,Emilija, AU - Marinkovic,Jelena, AU - Jovanovic,Lepa B, AU - Bumbasirevic,Vesna, PY - 2014/9/23/entrez PY - 2014/9/23/pubmed PY - 2014/12/15/medline KW - delirium KW - depressive symptoms KW - hip fracture KW - outcomes SP - 1640 EP - 8 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 62 IS - 9 N2 - OBJECTIVES: To analyze the incidence of the overlap syndrome of depressive symptoms and delirium, risk factors, and independent and dose-response effect of the overlap syndrome on outcomes in elderly adults with hip fracture. DESIGN: Prospective cohort study. SETTING: University hospital. PARTICIPANTS: Individuals with hip fracture without delirium (N = 277; aged 78.0 ± 8.2) consequently enrolled in a prospective cohort study. MEASUREMENTS: Depressive symptoms were assessed using the Geriatric Depression Scale and cognitive status using the Short Portable Mental Status Questionnaire upon hospital admission. Incident delirium was assessed daily during the hospital stay using the Confusion Assessment Method. Information on complications acquired in the hospital, severity of complications, re-interventions, length of hospital stay, and 1-month mortality was recorded. RESULTS: Thirty (10.8%) participants had depressive symptoms alone, 88 (31.8%) delirium alone, 60 (21.7%) overlap syndrome, and 99 (35.7%) neither condition. According to multivariate regression analysis, participants with the overlap syndrome had significantly higher incidence of vision impairment (P = .02), longer time-to-surgery (P = .03), and lower cognitive function (P < .001) than participants with no depressive symptoms and no delirium. In the adjusted regression analysis, participants with neither condition were at lower risk of complications than those with the overlap syndrome (P = .03). After adjustment, participants with the overlap syndrome were at higher risk of longer hospital stay independently (P = .003) and in a dose-response manner in the following order: no depression and no delirium, depressive symptoms alone, delirium alone, and the overlap syndrome (P = .002). CONCLUSION: Depressive symptoms and delirium increase the likelihood of adverse outcomes after hip fracture in a step-wise manner when they coexist. To reduce the risk of adverse outcome in individuals with hip fracture, efforts to identify, prevent, and treat this condition need to be increased. SN - 1532-5415 UR - https://www.unboundmedicine.com/medline/citation/25243678/Effect_of_the_overlap_syndrome_of_depressive_symptoms_and_delirium_on_outcomes_in_elderly_adults_with_hip_fracture:_a_prospective_cohort_study_ L2 - https://doi.org/10.1111/jgs.12992 DB - PRIME DP - Unbound Medicine ER -