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Yeganeh A, Haghighi M, Kazemi S, Amani H, Zareie B. Investigating the Prevalence of Depression in Older People With Hip Fractures. JROS 2024; 11 (2) :97-106
URL: http://jros.iums.ac.ir/article-1-2276-en.html

Background: A common complication during the healing of hip fractures is depression. It is recognized as a leading cause of disability in such patients. Older adults may face an increased risk of falls and fractures due to the effects of antidepressants or sedative medications. Patients with depression exhibit poorer recovery outcomes following fractures. 
Objectives: This study examines the prevalence of depression in elderly patients with trochanteric or peri-hip fractures. 
Methods: This cross-sectional study included all patients aged 65 years and older with trochanteric or peri-hip fractures who were admitted and treated in the orthopedic ward of Imam Khomeini Hospital, Urmia, Iran, in 2021. A demographic questionnaire was used to collect data, including age, gender, duration of depression diagnosis, place of residence, and history of psychiatric medication use. In the study title, we used the term “hip fractures” to broadly refer to various fractures in this area, including subtrochanteric and femoral head fractures. However, our analysis specifically focused on femoral neck and intertrochanteric fractures, as these are more prevalent in the elderly population we examined. 
Results: A total of 325 patients were included, with a mean age of 74.9±8.9 years; 172(52.9%) were male, and 153(47.1%) were female. Among the patients, 49.5% had femoral neck fractures, 43.4% had intertrochanteric fractures, and 7.1% had both types of fractures. Depression was diagnosed in 24 patients before the fracture, with an average duration of diagnosis of 7.2±4.6 years. The mean depression score at the time of fracture was 4.27±2.98, with 14 patients reporting a depression score of zero. Three months after the fracture, the mean depression score remained 4.27±2.98, with 11 patients reporting a depression score of zero. A paired samples t-test revealed no significant difference between depression levels at the time of the fracture and three months after the fracture (P=0.208). No significant differences in depression levels were observed between men (P=0.936) and women (P=0.077) three months after the fracture, though depression levels were slightly higher in women. Additionally, no significant differences in depression levels were found between the time of fracture and three months later in age groups 65–75 years and over 85 years (P>0.05). However, in the 75–85 years age group, a significant difference in depression levels was observed (P=0.022). Depression scores were 3.9, 4.6, and 5.2 for the 65–75 years, 75–85 years, and over 85 years age groups, respectively, indicating an increase in depression levels with age. No significant differences in depression levels were identified based on the duration of depression diagnosis, place of residence, income, or educational level (P>0.05). 
Conclusion: While depression levels did not significantly change three months after the fracture in most subgroups, the findings suggest that older age is associated with higher depression levels following hip fractures. These results underscore the importance of considering age-related psychological factors in the management of older patients with hip fractures.