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4/30/2001

Depression Raises Death Risk After Hip Fracture

Kate Traynor

Early diagnosis of depression in elderly patients recuperating from hip-repair surgery could save lives, say British researchers.

According to a report in the April 21 Lancet (PDF), seniors diagnosed with depression were 57 percent more likely than elderly patients with no mental illness to die within two years after fracturing a hip. The risk of death did not increase until more than a year after the fracture, prompting the researchers to call for early psychiatric testing and adequate follow-up of seniors after a hip fracture.

Dementia and delirium, the effects of which were apparent within six months after a fracture, took an even greater toll on life span. Two years after a hip fracture, seniors initially diagnosed with dementia or delirium were about 2.5 times as likely as patients with no mental illness to have died.

In all, 47 percent of the study participants had died within two years after undergoing hip-repair surgery.

A total of 731 patients ages 65 or older participated in the study, which was conducted at two British teaching hospitals. All seniors admitted to the hospitals for hip-repair surgery during a 19-month period were potentially eligible for the study.

The researchers used standard psychiatric diagnostic tests to determine each patient’s baseline mental state and diagnose depression, delirium, or dementia. Survival rates were assessed two years later by consulting the seniors’ general-care physicians or a health-service database. None of the seniors were lost to follow-up.

Seventy-two percent of the seniors were found to have at least one psychiatric illness when they entered the hospital for hip repair. Dementia, which affected 40 percent of the seniors, was the most common mental illness. Thirteen percent of the seniors were diagnosed with depression.

Sixty-six percent of the seniors diagnosed with depression, said the researchers, had not been prescribed a medication for this illness when the study began. The researchers did not evaluate the seniors’ use of medication or other therapy during follow-up.