Adverse effects of depression and cognitive impairment on rehabilitation participation and recovery from hip fracture
Objectives This study examines the effects of depression and cognitive impairment in elderly hip fracture patients receiving inpatient rehabilitation. Our goal was to determine whether any association of depression and cognitive impairment with rehabilitation outcome is accounted for by more immedia...
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| Veröffentlicht in: | International journal of geriatric psychiatry 2004-05, Vol.19 (5), p.472-478 |
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| container_title | International journal of geriatric psychiatry |
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| creator | Lenze, Eric J. Munin, Michael C. Dew, Mary Amanda Rogers, Joan C. Seligman, Karen Mulsant, Benoit H. Reynolds III, Charles F. |
| description | Objectives
This study examines the effects of depression and cognitive impairment in elderly hip fracture patients receiving inpatient rehabilitation. Our goal was to determine whether any association of depression and cognitive impairment with rehabilitation outcome is accounted for by more immediate effects of these variables on rehabilitation participation.
Methods
We measured depression using the Hamilton Rating Scale for Depression (Ham‐D), cognition using the Mini Mental State Examination (MMSE), and rehabilitation outcomes using the motor scale of the Functional Independence Measure (motor FIM) in a prospective observational study of 57 elderly rehabilitation hospital patients admitted to a university‐affiliated, freestanding rehabilitation hospital with primary diagnosis of hip fracture. We also assessed rehabilitation participation, to determine whether this accounted for (mediated) any relationship of depression and cognitive impairment with rehabilitation outcome.
Results
Baseline Ham‐D and MMSE scores were correlated with motor FIM efficiency—those with higher depressive symptoms had lower efficiency (r = −0.44, p |
| doi_str_mv | 10.1002/gps.1116 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_71955933</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>21104994</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5096-23754448ec9f6ff43becc50205075346061849d8fcd5e22f239358e81b684b5c3</originalsourceid><addsrcrecordid>eNqFkVuL1TAUhYMoznEU_AUSBMWXjklzafM4HPQoDqPjBR9Dmu7MZGybTtKOnn9vDi0qgviUHdaXtXf2QugxJSeUkPLl5ZhOKKXyDtpQolSRS3kXbUhdi0KWjByhByldE5I1Wt9HR1RQIQVXGzSftrcQE2BwDuyUcHC4hTFCSj4M2AwttuFy8JO_Bez70fjYwzDhrEW4Mo3v_GSmAzqaOHnrx-V2eBjBhmy-xy6GHl_5MRfGTnOEh-ieM12CR-t5jL68fvV5-6Y4e797uz09K6wgShYlqwTnvAarnHSOswZsVkoiSCUYl0TSmqu2drYVUJauZIqJGmrayJo3wrJj9HzxHWO4mSFNuvfJQteZAcKcdEWVEIqx_4IlpYQrxTP49C_wOsxxyJ_QZZ6LC8lVhl4skI0hpQhOj9H3Ju41JfoQmM6B6UNgGX2y-s1ND-1vcE0oA89WwCRrurzBwfr0B1cxugxWLNx338H-nw317sOntfHK-zTBj1-8id-0rPLe9dfznRbv2PbjOb3QF-wnrA67bw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>220545649</pqid></control><display><type>article</type><title>Adverse effects of depression and cognitive impairment on rehabilitation participation and recovery from hip fracture</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Lenze, Eric J. ; Munin, Michael C. ; Dew, Mary Amanda ; Rogers, Joan C. ; Seligman, Karen ; Mulsant, Benoit H. ; Reynolds III, Charles F.</creator><creatorcontrib>Lenze, Eric J. ; Munin, Michael C. ; Dew, Mary Amanda ; Rogers, Joan C. ; Seligman, Karen ; Mulsant, Benoit H. ; Reynolds III, Charles F.</creatorcontrib><description>Objectives
This study examines the effects of depression and cognitive impairment in elderly hip fracture patients receiving inpatient rehabilitation. Our goal was to determine whether any association of depression and cognitive impairment with rehabilitation outcome is accounted for by more immediate effects of these variables on rehabilitation participation.
Methods
We measured depression using the Hamilton Rating Scale for Depression (Ham‐D), cognition using the Mini Mental State Examination (MMSE), and rehabilitation outcomes using the motor scale of the Functional Independence Measure (motor FIM) in a prospective observational study of 57 elderly rehabilitation hospital patients admitted to a university‐affiliated, freestanding rehabilitation hospital with primary diagnosis of hip fracture. We also assessed rehabilitation participation, to determine whether this accounted for (mediated) any relationship of depression and cognitive impairment with rehabilitation outcome.
Results
Baseline Ham‐D and MMSE scores were correlated with motor FIM efficiency—those with higher depressive symptoms had lower efficiency (r = −0.44, p < 0.001); similarly, those with more cognitive impairment had lower motor FIM efficiency (r = 0.52, p < 0.001). Rehabilitation participation was a mediator of this association: greater depressive symptoms and cognitive impairment predicted poorer rehabilitation participation which, in turn, predicted lower motor FIM efficiency. Ham‐D and MMSE scores were predictors of discharge location: subjects with high depressive symptoms and greater cognitive impairment were more likely to go to a nursing home or personal care home upon discharge.
Conclusions
Depression and cognitive impairment are predictive of negative outcomes in elderly patients' rehabilitation from hip fracture. This effect is mediated by rehabilitation participation, and ratings in this area may serve as a potentially useful clinical and research tool for the rehabilitation environment. Copyright © 2004 John Wiley & Sons, Ltd.</description><identifier>ISSN: 0885-6230</identifier><identifier>EISSN: 1099-1166</identifier><identifier>DOI: 10.1002/gps.1116</identifier><identifier>PMID: 15156549</identifier><identifier>CODEN: IJGPES</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Aged ; Aged, 80 and over ; Biological and medical sciences ; cognition ; Cognition & reasoning ; Cognition Disorders - complications ; Depression - complications ; Female ; Fractures ; geriatric depression ; Geriatric psychiatry ; Geriatrics ; Hip Fractures - complications ; Hip Fractures - rehabilitation ; Hip joint ; Humans ; Injuries of the limb. Injuries of the spine ; Length of Stay ; Male ; Medical sciences ; Mental depression ; Middle Aged ; Patient Compliance - psychology ; Prospective Studies ; Psychiatric Status Rating Scales ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Rehabilitation ; Traumas. Diseases due to physical agents ; Treatment Outcome</subject><ispartof>International journal of geriatric psychiatry, 2004-05, Vol.19 (5), p.472-478</ispartof><rights>Copyright © 2004 John Wiley & Sons, Ltd.</rights><rights>2004 INIST-CNRS</rights><rights>Copyright 2004 John Wiley & Sons, Ltd.</rights><rights>Copyright John Wiley and Sons, Limited May 2004</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5096-23754448ec9f6ff43becc50205075346061849d8fcd5e22f239358e81b684b5c3</citedby><cites>FETCH-LOGICAL-c5096-23754448ec9f6ff43becc50205075346061849d8fcd5e22f239358e81b684b5c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fgps.1116$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fgps.1116$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15731994$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15156549$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lenze, Eric J.</creatorcontrib><creatorcontrib>Munin, Michael C.</creatorcontrib><creatorcontrib>Dew, Mary Amanda</creatorcontrib><creatorcontrib>Rogers, Joan C.</creatorcontrib><creatorcontrib>Seligman, Karen</creatorcontrib><creatorcontrib>Mulsant, Benoit H.</creatorcontrib><creatorcontrib>Reynolds III, Charles F.</creatorcontrib><title>Adverse effects of depression and cognitive impairment on rehabilitation participation and recovery from hip fracture</title><title>International journal of geriatric psychiatry</title><addtitle>Int. J. Geriat. Psychiatry</addtitle><description>Objectives
This study examines the effects of depression and cognitive impairment in elderly hip fracture patients receiving inpatient rehabilitation. Our goal was to determine whether any association of depression and cognitive impairment with rehabilitation outcome is accounted for by more immediate effects of these variables on rehabilitation participation.
Methods
We measured depression using the Hamilton Rating Scale for Depression (Ham‐D), cognition using the Mini Mental State Examination (MMSE), and rehabilitation outcomes using the motor scale of the Functional Independence Measure (motor FIM) in a prospective observational study of 57 elderly rehabilitation hospital patients admitted to a university‐affiliated, freestanding rehabilitation hospital with primary diagnosis of hip fracture. We also assessed rehabilitation participation, to determine whether this accounted for (mediated) any relationship of depression and cognitive impairment with rehabilitation outcome.
Results
Baseline Ham‐D and MMSE scores were correlated with motor FIM efficiency—those with higher depressive symptoms had lower efficiency (r = −0.44, p < 0.001); similarly, those with more cognitive impairment had lower motor FIM efficiency (r = 0.52, p < 0.001). Rehabilitation participation was a mediator of this association: greater depressive symptoms and cognitive impairment predicted poorer rehabilitation participation which, in turn, predicted lower motor FIM efficiency. Ham‐D and MMSE scores were predictors of discharge location: subjects with high depressive symptoms and greater cognitive impairment were more likely to go to a nursing home or personal care home upon discharge.
Conclusions
Depression and cognitive impairment are predictive of negative outcomes in elderly patients' rehabilitation from hip fracture. This effect is mediated by rehabilitation participation, and ratings in this area may serve as a potentially useful clinical and research tool for the rehabilitation environment. Copyright © 2004 John Wiley & Sons, Ltd.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>cognition</subject><subject>Cognition & reasoning</subject><subject>Cognition Disorders - complications</subject><subject>Depression - complications</subject><subject>Female</subject><subject>Fractures</subject><subject>geriatric depression</subject><subject>Geriatric psychiatry</subject><subject>Geriatrics</subject><subject>Hip Fractures - complications</subject><subject>Hip Fractures - rehabilitation</subject><subject>Hip joint</subject><subject>Humans</subject><subject>Injuries of the limb. Injuries of the spine</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mental depression</subject><subject>Middle Aged</subject><subject>Patient Compliance - psychology</subject><subject>Prospective Studies</subject><subject>Psychiatric Status Rating Scales</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Rehabilitation</subject><subject>Traumas. Diseases due to physical agents</subject><subject>Treatment Outcome</subject><issn>0885-6230</issn><issn>1099-1166</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkVuL1TAUhYMoznEU_AUSBMWXjklzafM4HPQoDqPjBR9Dmu7MZGybTtKOnn9vDi0qgviUHdaXtXf2QugxJSeUkPLl5ZhOKKXyDtpQolSRS3kXbUhdi0KWjByhByldE5I1Wt9HR1RQIQVXGzSftrcQE2BwDuyUcHC4hTFCSj4M2AwttuFy8JO_Bez70fjYwzDhrEW4Mo3v_GSmAzqaOHnrx-V2eBjBhmy-xy6GHl_5MRfGTnOEh-ieM12CR-t5jL68fvV5-6Y4e797uz09K6wgShYlqwTnvAarnHSOswZsVkoiSCUYl0TSmqu2drYVUJauZIqJGmrayJo3wrJj9HzxHWO4mSFNuvfJQteZAcKcdEWVEIqx_4IlpYQrxTP49C_wOsxxyJ_QZZ6LC8lVhl4skI0hpQhOj9H3Ju41JfoQmM6B6UNgGX2y-s1ND-1vcE0oA89WwCRrurzBwfr0B1cxugxWLNx338H-nw317sOntfHK-zTBj1-8id-0rPLe9dfznRbv2PbjOb3QF-wnrA67bw</recordid><startdate>200405</startdate><enddate>200405</enddate><creator>Lenze, Eric J.</creator><creator>Munin, Michael C.</creator><creator>Dew, Mary Amanda</creator><creator>Rogers, Joan C.</creator><creator>Seligman, Karen</creator><creator>Mulsant, Benoit H.</creator><creator>Reynolds III, Charles F.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>200405</creationdate><title>Adverse effects of depression and cognitive impairment on rehabilitation participation and recovery from hip fracture</title><author>Lenze, Eric J. ; Munin, Michael C. ; Dew, Mary Amanda ; Rogers, Joan C. ; Seligman, Karen ; Mulsant, Benoit H. ; Reynolds III, Charles F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5096-23754448ec9f6ff43becc50205075346061849d8fcd5e22f239358e81b684b5c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>cognition</topic><topic>Cognition & reasoning</topic><topic>Cognition Disorders - complications</topic><topic>Depression - complications</topic><topic>Female</topic><topic>Fractures</topic><topic>geriatric depression</topic><topic>Geriatric psychiatry</topic><topic>Geriatrics</topic><topic>Hip Fractures - complications</topic><topic>Hip Fractures - rehabilitation</topic><topic>Hip joint</topic><topic>Humans</topic><topic>Injuries of the limb. Injuries of the spine</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mental depression</topic><topic>Middle Aged</topic><topic>Patient Compliance - psychology</topic><topic>Prospective Studies</topic><topic>Psychiatric Status Rating Scales</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Rehabilitation</topic><topic>Traumas. Diseases due to physical agents</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lenze, Eric J.</creatorcontrib><creatorcontrib>Munin, Michael C.</creatorcontrib><creatorcontrib>Dew, Mary Amanda</creatorcontrib><creatorcontrib>Rogers, Joan C.</creatorcontrib><creatorcontrib>Seligman, Karen</creatorcontrib><creatorcontrib>Mulsant, Benoit H.</creatorcontrib><creatorcontrib>Reynolds III, Charles F.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of geriatric psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lenze, Eric J.</au><au>Munin, Michael C.</au><au>Dew, Mary Amanda</au><au>Rogers, Joan C.</au><au>Seligman, Karen</au><au>Mulsant, Benoit H.</au><au>Reynolds III, Charles F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adverse effects of depression and cognitive impairment on rehabilitation participation and recovery from hip fracture</atitle><jtitle>International journal of geriatric psychiatry</jtitle><addtitle>Int. J. Geriat. Psychiatry</addtitle><date>2004-05</date><risdate>2004</risdate><volume>19</volume><issue>5</issue><spage>472</spage><epage>478</epage><pages>472-478</pages><issn>0885-6230</issn><eissn>1099-1166</eissn><coden>IJGPES</coden><abstract>Objectives
This study examines the effects of depression and cognitive impairment in elderly hip fracture patients receiving inpatient rehabilitation. Our goal was to determine whether any association of depression and cognitive impairment with rehabilitation outcome is accounted for by more immediate effects of these variables on rehabilitation participation.
Methods
We measured depression using the Hamilton Rating Scale for Depression (Ham‐D), cognition using the Mini Mental State Examination (MMSE), and rehabilitation outcomes using the motor scale of the Functional Independence Measure (motor FIM) in a prospective observational study of 57 elderly rehabilitation hospital patients admitted to a university‐affiliated, freestanding rehabilitation hospital with primary diagnosis of hip fracture. We also assessed rehabilitation participation, to determine whether this accounted for (mediated) any relationship of depression and cognitive impairment with rehabilitation outcome.
Results
Baseline Ham‐D and MMSE scores were correlated with motor FIM efficiency—those with higher depressive symptoms had lower efficiency (r = −0.44, p < 0.001); similarly, those with more cognitive impairment had lower motor FIM efficiency (r = 0.52, p < 0.001). Rehabilitation participation was a mediator of this association: greater depressive symptoms and cognitive impairment predicted poorer rehabilitation participation which, in turn, predicted lower motor FIM efficiency. Ham‐D and MMSE scores were predictors of discharge location: subjects with high depressive symptoms and greater cognitive impairment were more likely to go to a nursing home or personal care home upon discharge.
Conclusions
Depression and cognitive impairment are predictive of negative outcomes in elderly patients' rehabilitation from hip fracture. This effect is mediated by rehabilitation participation, and ratings in this area may serve as a potentially useful clinical and research tool for the rehabilitation environment. Copyright © 2004 John Wiley & Sons, Ltd.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>15156549</pmid><doi>10.1002/gps.1116</doi><tpages>7</tpages></addata></record> |
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| ispartof | International journal of geriatric psychiatry, 2004-05, Vol.19 (5), p.472-478 |
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| subjects | Aged Aged, 80 and over Biological and medical sciences cognition Cognition & reasoning Cognition Disorders - complications Depression - complications Female Fractures geriatric depression Geriatric psychiatry Geriatrics Hip Fractures - complications Hip Fractures - rehabilitation Hip joint Humans Injuries of the limb. Injuries of the spine Length of Stay Male Medical sciences Mental depression Middle Aged Patient Compliance - psychology Prospective Studies Psychiatric Status Rating Scales Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Rehabilitation Traumas. Diseases due to physical agents Treatment Outcome |
| title | Adverse effects of depression and cognitive impairment on rehabilitation participation and recovery from hip fracture |
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