Does depression, apathy or cognitive impairment reduce the benefit of inpatient rehabilitation facilities for elderly hip fracture patients? - 22/08/11
, Elizabeth R. Skidmore, Ph.D. c, Mary Amanda Dew, Ph.D. a, Meryl A. Butters, Ph.D. a, Joan C. Rogers, Ph.D. c, Amy Begley, M.A. a, Charles F. Reynolds, M.D. a, Michael C. Munin, M.D. bAbstract |
Objective |
Depression, apathy (amotivation) and cognitive impairment are common comorbidities in hip fracture patients, which may adversely affect functional outcome of rehabilitation. We examined whether postfracture measures of mood, motivation or cognition are associated with rehabilitation outcome (defined as functional improvement) in inpatient rehabilitation facilities (IRFs), as compared to skilled nursing facilities (SNFs).
Methods |
This prospective study examined elderly patients who received surgical fixation for hip fracture and then received post-acute rehabilitation at an IRF or an SNF. Subjects were characterized at baseline for depression using the Hamilton Rating Scale for Depression, apathy/amotivation using the Apathy Evaluation Scale and mild-moderate cognitive impairment using the Mini-Mental Status Examination. Functional recovery was measured over 12-week follow-up using the Functional Independence Measure.
Results |
Fifty-eight subjects were discharged from acute care to an IRF and 39 to an SNF. Patients with depression, apathy or cognitive impairment who received rehabilitation at an IRF had significantly better functional outcomes than similarly impaired patients at SNFs, and similar outcomes such as nondepressed, motivated and cognitively intact elderly at IRFs.
Conclusion |
These findings suggest that depression, amotivation or mild-moderate cognitive impairment after hip fracture do not reduce the benefit of post-acute rehabilitation in an IRF.
Le texte complet de cet article est disponible en PDF.Keywords : Geriatric depression, Motivation, Cognition, Hip fracture, Rehabilitation
Plan
| ☆ | Dr. Lenze indicates he receives, or has received, grant/research support from Pfizer, Johnson & Johnson, and Forest. Dr. Munin indicates he receives grant/research support from Allergan, Inc. Dr. Reynolds indicates he receives, or has received, grant/research support from Glaxo Smith Kline, Forest, Pfizer, and Lilly. Drs. Skidmore, Dew, Butters, Rogers, and Ms Begley have no potential conflicts to report. |
| ☆☆ | Dr. Lenze was the principal investigator of this study and oversaw all aspects of it, and wrote the manuscript. Dr. Munin had a role in study design, data acquisition, and data interpretation and preparation of the manuscript. Dr. Dew had a role in study design, data acquisition, and data interpretation and preparation of the manuscript. Dr. Skidmore had a role in study design, data acquisition, and data interpretation and preparation of the manuscript. Dr. Rogers had a role in study design, data acquisition, and data interpretation and preparation of the manuscript. Dr. Butters had a role in data interpretation and preparation of the manuscript. Ms. Begley had a role in data interpretation and preparation of the manuscript. Dr. Reynolds had a role in study design, data acquisition, and data interpretation and preparation of the manuscript. |
| ★ | The sponsor, NIMH, had no role in the design, methods, subject recruitment, data collection, analysis or preparation of the paper. |
Vol 29 - N° 2
P. 141-146 - mars 2007 Retour au numéro
Article précédent
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