Effects of Prefracture Depressive Illness and Postfracture Depressive Symptoms on Physical Performance After Hip Fracture

• Autores: Alan M. Rathbun, Michelle Shardell, Denise Orwig, Glenn V. Ostir, Gregory E. Hicks, Ram R. Miller, Marc Hochberg, Jay Magaziner
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 64, Nº. 11, 2, 2016, págs. 171-176
• Idioma: inglés
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  • 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.