A comparative study of depression in elderly men and women following major fractures

G Naveen Bharat; P R Sudheendra; G V Shiva Kumar; D S Kushal

doi:10.53730/ijhs.v6nS2.6855

Authors

G Naveen Bharat Assistant Professor, Department Of Orthopaedics, Mcgann Teaching Hospital, Shimoga Institute Of Medical Sciences, Shivamogga
Sudheendra P R Associate Professor, Department Of Orthopaedics, Mcgann Teaching Hospital, Shimoga Institute Of Medical Sciences, Shivamogga
Shiva Kumar G V Assistant Professor, Department Of Orthopaedics, Mcgann Teaching Hospital, Shimoga Institute Of Medical Sciences, Shivamogga
Kushal D S
drkushalds@gmail.com
Assistant Professor, Department Of Orthopaedics, Mcgann Teaching Hospital, Shimoga Institute Of Medical Sciences, Shivamogga

Keywords:

depression, fracture, elderly

Abstract

Background: Depression accounts for approximately 8.2% of people living with disability worldwide. Depression and fractures are a common occurrence especially elderly who are predisposed to fractures due to low bone mineral density. Clinical Depression is linked to high cortisol levels and low mineral density. As most studies correlating fractures in the elderly and its association with depression have been done in the western countries, we felt the need to pursue a study to compare fractures in elderly men and women and its association with depression in the Indian population. Methods: This was a prospective study done over two years with continuous sampling method. The study included 90 inpatients (51males and 39females) with fractures of long bone and hip needing prolonged rehabilitation. Patients above 65 years of age admitted with fractures of long bones and hip were examined using Beck’s depression inventory. The data was tabulated and compared between males and females. Results: We found 58.96% of females suffered from some form of depression as opposed to 39.21% of males. We found statistically significant association between depression and female suffering from major fractures.

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References

Williams LJ, Berk M, Henry MJ, et al. Depression following fracture in women: a study of age-matched cohorts. BMJ Open 2014;4: e004226. doi:10.1136/ bmjopen-2013-004226.

So Young Kim, Joon Kyu Lee, Dong Jun Oh, Gyu Kong, Hyo Geun Choi. Depression and incident hip fracture A longitudinal follow-up study using a national sample cohort. Medicine (2019) 98:26(e16268)

Chang C-Y, Chen W-L, Liou Y-F, Ke C-C, Lee H-C, et al. (2014) Increased risk of major depression in the three years following a femoral neck f racture–A National Population-Based Follow-Up Study. PLoS ONE 9(3): e89867. doi:10.1371/journal.pone.0089867

Cooper C, Campion G, Melton LJ. Hip fractures in the elderly: A world-wide projection. Osteoporos Int 1992;2:285-9.

Baxter AJ, Charlson FJ, Somerville AJ, et al. Mental disorders as risk factors: assessing the evidence for the Global Burden of Disease Study. BMC Med 2011;9:134. doi: 10.1186/1741-7015-9-134.

Phillips AC, Jane Upton, Duggal NA, Carrol D, Lord JM. Depression following hip fracture is associated with increased physical frailty in older adults: the role of the cortisol: dehydroepiandrosterone sulphate ratio. BMC Geriatrics 2013 13:60.

Michelson D, Stratakis C, Hill L. Bone mineral density in women with depression. N Engl J Med. 1996;335:1176–81.

Peeters GM, van Schoor NM, van Rossum EF, Visser M, Lips P: The relationship between cortisol, muscle mass and muscle strength in older persons and the role of genetic variations in the glucocorticoid receptor. Clin Endocrinol. 2008;69(4):673–682.

Peeters GM, van Schoor NM, Visser M, Knol DL, Eekhoff EM, de Ronde W, Lips P: Relationship between cortisol and physical performance in older persons. Clin Endocrino. 2007;67(3):398–406.

Sudheendra PR, Ramprasad KS, Manjunath Rajashekharaiah. Depression following fracture in adults: Comparative study between men and women at a tertiary care centre. Int J Med Res Rev 2015;3(7):706-711. doi: 10.17511/ijmrr.2015.i7.133.

Cheng BH, Chen PC, Yang YH, et al. Effects of depression and antidepressant medications on hip fracture: a population-based cohort study in Taiwan. Medicine (Baltimore) 2016;95:e4655. doi: 10.1097/ MD.0000000000004655.

Briggs R, Kennelly SP, Kenny RA. Does baseline depression increase the risk of unexplained and accidental falls in a cohort of communitydwelling older people? Data from The Irish Longitudinal Study on Ageing (TILDA). Int J Geriatr Psychiatry 2018;33:e205–11

Burns A, Younger J, Morris J, et al. Outcomes following hip fracture surgery: a 2-year prospective study. Am J Geriatr Psychiatry 2014; In press.

Weng TY, Chen LC, Shyu HW, et al. Lactoferrin inhibits enterovirus 71 infection by binding to VP1 protein and host cells. Antiviral Res 2005;67:31–7.

Bellelli G, Frisoni GB, Turco R, et al. Depressive symptoms combined with dementia affect 12-months survival in elderly patients after rehabilitation post-hip fracture surgery. Int J Geriatr Psychiatry 2008;23:1073–7.

Holmes JD, House AO. Psychiatric illness in hip fracture. Age Ageing 2000;29:537–46

Silverman SL, Shen W, Minshall ME, et al. Prevalence of depressive symptoms in postmenopausal women with low bone mineral density and/or prevalent vertebral fracture: results from the Multiple Outcomes of Raloxifene Evaluation (MORE) study. J Rheumatol 2007;34:140–4

Lenze EJ, Munin MC, Dew MA, et al. Adverse effects of depression and cognitive impairment on rehabilitation participation and recovery from hip fracture. Int J Geriatr Psychiatry 2004;19:472–8.

Mossey JM, Knott K, Craik R. The effects of persistent depressive symptoms on hip fracture recovery. J Gerontol 1990; 45:M163–168.

Otmar R, Reventlow S, Morrow M, et al. A cultural models approach to osteoporosis prevention and treatment. Sage Open 2012:1–16.

Wu Q, Liu B, Tonmoy S. Depression and risk of fracture and bone loss: an updated meta-analysis of prospective studies. Osteoporos Int 2018;29:1303–12.

Zhang J, Lam SP, Li SX, et al. Parental history of depression and higher basal salivary cortisol in unaffected child and adolescent offspring. J Affect Disord 2018;234:207–13.

Herbert J. Cortisol and depression: three questions for psychiatry. Psychol Med 2013;43:449–69.

Wang T, Yu X, He C. Pro-inflammatory cytokines: cellular and molecular drug targets for glucocorticoid-induced-osteoporosis via osteocyte. Curr Drug Targets 2019;20:1–15.

Duignan D, Woodward Y, Daniel E, Burns A. An intervention to manage depression after hip fracture. Nursing Times. 2007;103(28):32–33.