Effects of Prefracture Depressive Illness and Postfracture Depressive Symptoms on Physical Performance After Hip Fracture.
To compare the effect of prefracture depressive illness and postfracture depressive symptoms on changes in physical performance after hip fracture.



Longitudinal observational cohort.



Baltimore metropolitan area.



Older adults with hip fracture (N = 255).



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.



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.



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.
Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland.
Alan M
AM
Rathbun
Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland.
Michelle
M
Shardell
Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland.
Denise
D
Orwig
Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland.
Ann L
AL
Gruber-Baldini
Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland.
Glenn
G
Ostir
Department of Physical Therapy, University of Delaware, Newark, Delaware.
Gregory E
GE
Hicks
Novartis Institutes of BioMedical Research, Cambridge, Massachusetts.
Ram R
RR
Miller
Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland.
Marc C
MC
Hochberg
Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland.
Jay
J
Magaziner
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015142:Baltimore; D003866:Depressive Disorder / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006620:Hip Fractures / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010808:Physical Examination / Q000379:methods; D011569:Psychiatric Status Rating Scales; D020127:Recovery of Function / Q000502:physiology*; D012307:Risk Factors; D013223:Statistics as Topic; D013647:Task Performance and Analysis; D013997:Time Factors
depression; hip fracture; physical performance
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