title: Depressive symptoms combined with dementia affect 12-months survival in elderly patients after rehabilitation post-hip fracture surgery.
abstract: OBJECTIVE
  To assess whether the association of depression and dementia affects 12-month survival of elderly patients after rehabilitation post-hip fracture (HF) surgery.
  
  
  METHODS
  Two hundred eleven inpatients admitted to a Rehabilitation and Aged Care Unit (RACU) following surgery for HF were screened for depression with the 15-item Geriatric Depression Scale (GDS) and stratified into four groups according to dementia (n = 40), depressive symptoms (n = 54, GDS score > 7/15), both (n = 27), and neither conditions (n = 90). The 12-months survival after discharge was assessed among groups with Kaplan Meyer analysis and compared with Cox proportional hazard regression models adjusted for covariates. Subjects with neither depression nor dementia were the reference group.
  
  
  RESULTS
  Survival of patients with depression and dementia was significantly lower than the other 3 groups: after adjustment for age, gender, comorbidity (Charlson Index), use of antidepressants, and Barthel Index at discharge, their Hazard Ratio (HR) was 8.7 (95% CI 1.5-48.5; p = 0.01); in the same Cox regression model, the HR of patients with dementia alone was 3.4 (95% CI 0.5-24.0; p = 0.20) while the HR of patients with depressive symptoms but no dementia was 5.0 (95% CI 0.8-28.3; p = 0.07).
  
  
  CONCLUSIONS
  The co-occurrence of depression and dementia significantly increases the 12-months risk of dying in elderly patients after rehabilitation post-HF surgery.
authors.affiliation: Rehabilitation and Aged Care Unit, Ancelle della Carità Hospital Cremona, Brescia, Italy. giuseppebellelli@libero.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bellelli
authors.forename: Giovanni B
authors.initials: GB
authors.lastname: Frisoni
authors.forename: Renato
authors.initials: R
authors.lastname: Turco
authors.forename: Marco
authors.initials: M
authors.lastname: Trabucchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000150:complications* / Q000401:mortality; D003863:Depression / Q000150:complications* / Q000401:mortality; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006620:Hip Fractures / Q000523:psychology* / Q000534:rehabilitation / Q000601:surgery; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D012306:Risk; D015996:Survival Rate