期刊
AGE AND AGEING
卷 50, 期 6, 页码 1943-1951出版社
OXFORD UNIV PRESS
DOI: 10.1093/ageing/afab168
关键词
hip fracture; depression; heterogeneity; physical performance; older people
资金
- National Institute on Aging [K01 AG064041, R37 AG009901, R01 AG029315, P30 AG028747, T32 AG000262]
Four patterns of depressive symptoms were identified among older adults after hip fracture: asymptomatic, somatic, melancholic, and anhedonic. Somatic symptoms were associated with difficulties in concentration and reduced energy and movement, while anhedonic symptoms were linked to the inability to experience pleasure. Melancholic symptoms corresponded to anhedonia, decreased physical activity, and other psychological and somatic complaints.
Objective: to evaluate patterns of depressive symptoms after hip fracture and examine their impact on functional recovery. Methods: participants (n = 304) included older adults from the Baltimore Hip Studies 7th cohort who experienced a hip fracture. Depressive symptoms weremeasured at baseline or 2-, 6- or 12-month post-hip fracture using the 20-item Center for Epidemiologic Studies Depression scale. Gait speed was measured after hip fracture at 2-, 6- or 12-month follow-up. Latent class analysis was used to identify individuals with similar patterns of depressive symptoms after hip fracture. Item response probabilities characterised symptom profiles, and posterior probability estimates were used to assign participants to a baseline depressive symptom subtype. Weighted estimated equations compared post-fracture gait speed between baseline symptomatic and asymptomatic groups. Results: four patterns of depressive symptoms were identified: asymptomatic (50.8%), somatic (28.6%), melancholic (11.4%) and anhedonic (9.2%). The somatic subtype was characterised by difficultly concentrating and reduced energy andmovement, whereas anhedonic symptoms were associated with the inability to experience pleasure. Melancholic symptoms corresponded to anhedonia, decreased physical activity and other psychological and somatic complaints. Compared with the asymptomatic group, somatic symptoms were consistently associated with slower gait speed, -0.03 metres per second (m/s) and between-group differences for melancholic symptomology were as large as -0.05 m/s, but the associations were not statistically significant. Conclusion: findings demonstrate unique depressive symptom subtypes in older adults after hip fracture and provide confirmatory evidence of unique clinical phenotypes; however, their impact on functional recovery after hip fracture remains unclear.
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