Depression may slow recovery in people with hip fracture

 People who have hip fracture and are depressed may have delayed recovery compared to those without depression, says a study published in BMC Geriatrics.

A team from the University of Birmingham interviewed 101 people with hip fracture six weeks and six months after their injury. They were compared with 43 healthy volunteers.

Before the hip fracture, none of the volunteers had a history of depression.

A total of 38 people with hip fracture had symptoms of depression six weeks after the injury occurred, and most were still depressed at six months. They were less able to cope with daily living activities, had worse balance at week six and had a slower walking speed at six months than people who were not depressed.

“Depression following hip fracture is associated with greater physical frailty and poorer long-term recovery post-injury,” the authors say.

It could be that hormones play a role, however, as the study showed that the depressed group tended to have an increased ratio of two hormones: a stress hormone called cortisol and another powerful hormone called dehydroepiandrosterone sulphate. The team involved go as far to suggest that correcting the ratio by supplementing DHEA could help.

“Although the priority for older hip fracture patients is surgery to mend the fracture, it is also very important to understand and measure the factors that affect wellbeing and recovery once individuals leave hospital,” says Dr Anna Phillips who was involved in the work. “Depression is one such factor which can affect resistance to disease and physical function as well as obviously quality of life and mental wellbeing; identifying and treating this depression is therefore key to a good recovery.”