Interdisciplinary intervention reduced the risk of being persistently depressive among older patients with hip fracture.
OBJECTIVE
To assess the effects of an interdisciplinary intervention on the trajectories of depressive symptoms among older patients during 2 years after hip fracture surgery.


METHODS
A secondary analysis of data from a randomized controlled trial that contrasted usual care with an interdisciplinary program. Whereas usual care (n = 77) entailed only in-hospital rehabilitation and occasional discharge planning, the interdisciplinary program (n = 76) consisted of geriatric consultation, in-hospital rehabilitation, discharge planning and rehabilitation at home for 3 months after hospitalization. Depressive symptoms were assessed by using the Chinese version of the Geriatric Depression Scale short-form, before discharge, and 1, 3, 6, 12, 18 and 24 months after discharge. Covariates included demographic attributes, pre-fracture performance of activities of daily living (Chinese Barthel Index) and cognitive functioning (Mini-Mental State Examination).


RESULTS
Changes in depressive symptoms can be characterized by three trajectory groups, including a non-depressive group (n = 58, 37.8%), a marginally depressive group (n = 46, 30.7%) and a persistently depressive group (n = 49, 31.5%). Relative to those who received usual care, participants in the interdisciplinary program had a significantly lower risk of being in the persistently depressive group (odds ratio 0.23, P < 0.05). In addition, women and those physically and cognitively more impaired were more likely to be in the marginally and persistently depressive groups.


CONCLUSIONS
Our interdisciplinary intervention reduced older persons' likelihood of having persistent depressive symptoms after hip fracture surgery. Geriatr Gerontol Int 2016; 16: 1145-1152.
Department of Nursing, MeiHo University, Pingtung, Taiwan.
Ming-Yueh
MY
Tseng
School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.|Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
Yea-Ing L
YL
Shyu
School of Public Health, University of Michigan, Ann Arbor, Michigan, USA. jliang@umich.edu.|Institute of Gerontology, University of Michigan, Ann Arbor, Michigan, USA. jliang@umich.edu.
Jersey
J
Liang
Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.|College of Medicine, National Taiwan University, Taipei, Taiwan.
Wen-Che
WC
Tsai
D000368:Aged; D000369:Aged, 80 and over; D003866:Depressive Disorder / Q000517:prevention & control* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000401:mortality / Q000523:psychology* / Q000601:surgery; D006801:Humans; D008297:Male; D010348:Patient Care Team / Q000458:organization & administration*; D011788:Quality of Life; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome
depressive symptoms; hip fracture elders; interdisciplinary intervention; randomized controlled trial