title: Increased risk of major depression in the three years following a femoral neck fracture--a national population-based follow-up study.
abstract: Femoral neck fracture is common in the elderly, and its impact has increased in aging societies. Comorbidities, poor levels of activity and pain may contribute to the development of depression, but these factors have not been well addressed. This study aims to investigate the frequency and risk of major depression after a femoral neck fracture using a nationwide population-based study. The Taiwan Longitudinal Health Insurance Database was used in this study. A total of 4,547 patients who were hospitalized for femoral neck fracture within 2003 to 2007 were recruited as a study group; 13,641 matched non-fracture participants were enrolled as a comparison group. Each patient was prospectively followed for 3 years to monitor the occurrence of major depression. Cox proportional-hazards models were used to compute the risk of major depression between members of the study and comparison group after adjusting for residence and socio-demographic characteristics. The most common physical comorbidities that were present after the fracture were also analyzed. The incidences of major depression were 1.2% (n = 55) and 0.7% (n = 95) in the study and comparison groups, respectively. The stratified Cox proportional analysis showed a covariate-adjusted hazard ratio of major depression among patients with femoral neck fracture that was 1.82 times greater (95% CI, 1.30-2.53) than that of the comparison group. Most major depressive episodes (34.5%) presented within the first 200 days following the fracture. In conclusion, patients with a femoral neck fracture are at an increased risk of subsequent major depression. Most importantly, major depressive episodes mainly occurred within the first 200 days following the fracture.
authors.affiliation: Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan; Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan; Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan.
authors.forename: Chih-Yu
authors.initials: CY
authors.lastname: Chang
authors.affiliation: Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.
authors.forename: Wen-Liang
authors.initials: WL
authors.lastname: Chen
authors.affiliation: Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan.
authors.forename: Yi-Fan
authors.initials: YF
authors.lastname: Liou
authors.affiliation: Institute of Multimedia Engineering, National Chiao Tung University, Hsinchu, Taiwan.
authors.forename: Chih-Chi
authors.initials: CC
authors.lastname: Ke
authors.affiliation: Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.
authors.forename: Hua-Chin
authors.initials: HC
authors.lastname: Lee
authors.affiliation: Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan; Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan.
authors.forename: Hui-Ling
authors.initials: HL
authors.lastname: Huang
authors.affiliation: Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan.
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Ciou
authors.affiliation: Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan; School of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chu-Chung
authors.initials: CC
authors.lastname: Chou
authors.affiliation: Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Mei-Chueh
authors.initials: MC
authors.lastname: Yang
authors.affiliation: Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan; Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan.
authors.forename: Shinn-Ying
authors.initials: SY
authors.lastname: Ho
authors.affiliation: Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan; Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Yan-Ren
authors.initials: YR
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015897:Comorbidity; D016208:Databases, Factual; D003865:Major Depressive Disorder / Q000150:complications* / Q000209:etiology; D005260:Female; D005265:Femoral Neck Fractures / Q000150:complications / Q000523:psychology*; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D013624:Taiwan; D055815:Young Adult