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Effects of Prefracture Depressive Illness and Postfracture Depressive Symptoms on Physical Performance After Hip Fracture
Author(s) -
Rathbun Alan M.,
Shardell Michelle,
Orwig Denise,
GruberBaldini Ann L.,
Ostir Glenn,
Hicks Gregory E.,
Miller Ram R.,
Hochberg Marc C.,
Magaziner Jay
Publication year - 2016
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.14487
Subject(s) - medicine , depression (economics) , hip fracture , depressive symptoms , physical therapy , psychiatry , osteoporosis , cognition , economics , macroeconomics
Objectives To compare the effect of prefracture depressive illness and postfracture depressive symptoms on changes in physical performance after hip fracture. Design Longitudinal observational cohort. Setting Baltimore metropolitan area. Participants Older adults with hip fracture (N = 255). Measurements Prefracture depressive illness (from medical records) at baseline and postfracture depressive symptoms at 2 months (using the Center for Epidemiologic Studies Depression Scale) were measured. Physical performance was measured 2, 6, and 12 months after fracture using the Short Physical Performance Battery ( SPPB ), a composite metric of functional status with a score ranging from 0 to 12. Weighted estimating equations were used to assess mean SPPB over time, comparing participants with and without prefracture depressive illness and subjects with and without postfracture depressive symptoms. Results Participants with prefracture depressive illness had an SPPB increase of 0.4 units (95% confidence interval ( CI ) = −0.5–1.3) from 2 to 6 months, smaller than the increase of 1.0 SPPB unit (95% CI = 0.4–1.6) in those without prefracture depressive illness. Participants with postfracture depressive symptoms had an SPPB increase of 0.2 units (95% CI = −1.0–1.5) from 2 to 12 months, and those without postfracture depressive symptoms had a larger increase of 1.2 units (95% CI = 0.6–1.8) over the same period. Nevertheless, prefracture depressive illness and postfracture depressive symptoms were not significantly associated with SPPB . Conclusions Neither prefracture depressive illness nor postfracture depressive symptoms were significantly associated with changes in physical performance after hip fracture, but the magnitude of estimates suggested possible clinically meaningful effects on functional recovery.