Adverse effects of depression and cognitive impairment on rehabilitation participation and recovery from hip fracture

Lenze, Eric J.; Munin, Michael C.; Dew, Mary Amanda; Rogers, Joan C.; Seligman, Karen; Mulsant, Benoit H.; Reynolds, Charles F.

doi:10.1002/gps.1116

Cited by 200 publications

(172 citation statements)

References 26 publications

(22 reference statements)

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“…When depressed, persons who have suffered a hip fracture are less likely to participate in rehabilitation activities and recover more slowly. 70 Improvement in level of disability during rehabilitation is associated with improved mood. 71 Age, medical comorbidity, level of disability before and after the fracture, apathy, delirium, cognitive impairment, and poor social support are all risk factors for the development of depression after hip fracture.…”

Section: Depression Antidepressants and Fracturesmentioning

confidence: 99%

The Complex Interplay of Depression and Falls in Older Adults: A Clinical Review

Iaboni

Flint

2013

The American Journal of Geriatric Psychiatry

220

178

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Depression and falls have a significant bidirectional relationship. Excessive fear of falling, which is frequently associated with depression, also increases the risk of falls. Both depression and fear of falling are associated with impairment of gait and balance, an association that is mediated through cognitive, sensory, and motor pathways. The management of depression in fall-prone individuals is challenging, since antidepressant medications can increase the risk of falls, selective serotonin reuptake inhibitors may increase the risk of fragility fractures, and data are lacking about the effect of fall rehabilitation programs on clinically significant depression. Based on the current state of knowledge, exercise (particularly Tai Chi) and cognitive-behavioral therapy should be considered for the first-line treatment of mild depression in older fallers. Antidepressant medications are indicated to treat moderate to severe depression in fall-prone individuals, but with appropriate precautions including low starting dose and slow dose titration, use of psychotropic monotherapy whenever possible, and monitoring for orthostatic hypotension and hyponatremia. To date, there have been no recommendations for osteoporosis monitoring and treatment in individuals prescribed antidepressant medications, beyond the usual clinical guidelines. However, treatment of the older depressed person who is at risk of falls provides the opportunity to inquire about his or her adherence with osteoporosis and fracture-prevention guidelines. KeywordsAntidepressants; depression; falls; fear of falling; fractures One-third of community-dwelling seniors fall each year, with half of these individuals falling more than once. Ten percent of all falls result in a major injury, which can lead to institutionalization and death. 1 Falls often result in a fear of further falls, leading to fearrelated restriction of activities: this activity restriction has been associated with subsequent impairment in balance, mobility, and disability. 2,3 Send correspondence and reprint requests to Alastair

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Section: Depression Antidepressants and Fracturesmentioning

confidence: 99%

The Complex Interplay of Depression and Falls in Older Adults: A Clinical Review

Iaboni

Flint

2013

The American Journal of Geriatric Psychiatry

220

178

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“…En una cohorte de 59 personas mayores con fractura de cadera y deterioro cognitivo seguidas durante su proceso de rehabilitación, la mayor presencia de síntomas depresivos se correlacionó a menores resultados en la eficiencia del FIM motor (r = -0,44, p < 0,001), mayor estancia hospitalaria (r = 0,57, p < 0,001), y a una menor participación en el tratamiento (r = -0,46, p < 0,001). En relación al destino al alta, el 58% de los sujetos que presentaban mayor intensidad de síntomas depresivos presentaban como destino al alta una residencia de larga estadía en comparación al 12% de aquellos que no reportaban síntomas depresivos o síntomas leves (c 2 = 9,1, df = 1, p < 0,003) 27,28 .…”

Section: Depresión Y Rehabilitación En La Persona Mayorunclassified

Comprendiendo el impacto de los síntomas depresivos en la funcionalidad de las personas mayores

Aravena

2017

Rev. chil. neuro-psiquiatr.

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“…De acordo com Lenze et al 13 , a depressão e o déficit cognitivo são preditores de resultados negativos na reabilitação de idosos que tiveram fratura de quadril.…”

Section: Fratura De Quadril Como Fator De Risco Para a Depressãounclassified

Prevalência de depressão em mulheres idosas com fratura de quadril

Demetrio

Gattaz

et al. 2009

Rev. psiquiatr. clín.

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Adverse effects of depression and cognitive impairment on rehabilitation participation and recovery from hip fracture

Cited by 200 publications

References 26 publications

The Complex Interplay of Depression and Falls in Older Adults: A Clinical Review

The Complex Interplay of Depression and Falls in Older Adults: A Clinical Review

Comprendiendo el impacto de los síntomas depresivos en la funcionalidad de las personas mayores

Prevalência de depressão em mulheres idosas com fratura de quadril

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