Depression and risk of hip fracture: a systematic review and meta-analysis of cohort studies

Shi, Tingting; Min, Michelle; Zhang, Y; Sun, Chenyu; Liang, Mingming; Sun, Yehuan

doi:10.1007/s00198-019-04951-6

Cited by 28 publications

(24 citation statements)

References 48 publications

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“…35,36 A recent systematic review suggested that people with depressive symptoms are at increased risk of hip fractures, although relatively few (n ¼ 5) studies included people with confirmed depression. 37 A meta-analysis suggested that people with major depression were at increased risk of future falls, but the sample size was small (n ¼ 965). 38 Minimal information is available on falls and hip fractures in older adults with bipolar disorder, substance use disorder, or anxiety-and stress-related disorders to date.…”

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confidence: 99%

Risk of Hospitalized Falls and Hip Fractures in 22,103 Older Adults Receiving Mental Health Care vs 161,603 Controls: A Large Cohort Study

Stubbs

Perara

Koyanagi

et al. 2020

Journal of the American Medical Directors Association

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Objectives: To investigate the risk of hospitalized fall or hip fracture among older adults using mental health services. Design: Retrospective cohort study. Setting and Participants: Residents of a South London catchment aged >60 years receiving specialist mental health care between 2008 and 2016. Measures: Falls and/or a hip fracture leading to hospitalization were ascertained from linked national records. Incidence rates and incidence rate ratios (IRRs) were age-and gender-standardized to the catchment population. Multivariable survival analyses were applied investigating falls and/or hip fractures as outcomes. Results: In 22,103 older adults, incidence rates were 60.1 per 1000 person-years for hospitalized falls and 13.7 per 1000 person-years for hip fractures, representing standardized IRRs of 2.17 [95% confidence interval (CI) 2.07-2.28] and 4.18 (3.79-4.60), respectively. The IRR for falls was high in those with substance-use disorder [IRR ¼ 6.72 (5.35-8.33)], bipolar disorder [IRR ¼ 3.62 (2.50-5.05)], depression [IRR ¼ 2.28 (2.00-2.59)], and stress-related disorders [IRR ¼ 2.57 (2.10-3.11)]. Hip fractures were increased in all populations (IRR > 2.5), with greatest risk in substance use disorders )], dementia .00)], and delirium [IRR ¼ 4.03 (3.00-5.29)]. Comparing mental disorder subgroups with each other, after the adjustment for 25 potential confounders, patients with dementia and substance use had a significantly increased risk of falls, and patients with dementia also had an increased risk of hip fractures. Conclusion and Implications: Older people using mental health services have more than double the incidence of falls and 4 times the incidence of hip fractures compared to the general population. Although incidences differ between diagnostic subgroups, all groups have a higher incidence than the The authors declare no conflicts of interest.

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confidence: 99%

Risk of Hospitalized Falls and Hip Fractures in 22,103 Older Adults Receiving Mental Health Care vs 161,603 Controls: A Large Cohort Study

Stubbs

Perara

Koyanagi

et al. 2020

Journal of the American Medical Directors Association

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“…In the meta-analysis study conducted by Shi TT et al, The incidence of hip fracture is more common in individuals with depression than in normal individuals. The mortality risk is also very high in these patients [24].…”

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confidence: 92%

The effect of nutrition, depression, activity scores on mortality in patients with geriatric hip fractures.

Çamur¹,

Özcan²,

Sönmez

et al. 2020

Archives of Clinical and Experimental Medicine

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Aim: Hip fracture causes high mortality rates in elderly patients. Here we investigate the relationship between serum laboratory parameters, bone densitometers, malnutrition, depression and pre-fracture survival activity scores of patients who died within 24 months after surgery for hip fracture. Methods: 121 patients who underwent surgery for hip fracture between 2013 and 2016 and who met the study criteria were evaluated retrospectively. The patients who died within the first 24 months after surgery were evaluated as Group 1, and the patients who died after 24 months or who were still alive were evaluated as Group 2. Serum parameters before surgery, hip and vertebra bone densitometry were examined. The Barthel and Lawton Life Scale was completed, Mini nutritional assesment (MNA), geriatric depression scala short form (GDS-SF) and preoperative length of stay and BMI were evaluated. Results: Comparing the parameters between groups, we detected no significant difference between age, BMI, vertebral BMD preoperative length of stay. Albumin, total protein, hip BMD, barthel score, and the lawton scoring system, GDS-FM, MNA showed significant differences between the two groups (P<0.05). According to the regression analysis, Albumin, total protein, MNA, GDS-SF, Barthel Score and Lawton Scoring Systems showed a significantly correlation in patients with mortality in the first 24 months (P<0.05). Conclusion: Geriatric hip fractures have many factors that determine the risk of mortality within the first 24 months. According to our study, low albumin, total protein , malnutrition, high depression as well as low pretreatment activity scores, indicate high mortality risk in the 24 months.

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“…Importantly, drugs that treat depression may be associated with sedation and impaired psychomotor reflexes and may thereby themselves predispose to falls and fractures. In the same meta-analysis, 7 depression was significantly associated with fracture risk in studies that adjusted for antidepressant use (k = 5; HR, 1.12; 95% CI, 1.01-1.25) as well as in studies that did not adjust for antidepressant use (k = 8; HR, 1.32; 95% CI, 1.17-1.50). The attenuation of the HR in the studies that adjusted for antidepressant use suggests that antidepressants might contribute to the risk.…”

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confidence: 95%

“…There are many reasons why depression may increase the risk of incident fracture 7 : depression is associated with poor diet, smoking, alcohol intake, sedentariness, poor adherence to medical advice, and other health-related behaviors that may predispose to osteopenia and osteoporosis; depression is associated with low vitamin D levels, hypercortisolemia, and other hormonal changes that affect bone resorption and/or formation; depression is associated with elevated levels of inflammatory cytokines that are linked to decreased bone mineral density; depression is associated with a variety of medical comorbidities that can independently increase the risk of fractures; last but not least, depression is associated with cognitive slowing, psychomotor retardation, impaired judgement, and other changes that may affect gait, balance, and precautionary behavior against falls.…”

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confidence: 99%

Antidepressant Drugs and the Risk of Hip Fracture in the Elderly

Andrade¹

2019

J. Clin. Psychiatry

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Depression and risk of hip fracture: a systematic review and meta-analysis of cohort studies

Cited by 28 publications

References 48 publications

Risk of Hospitalized Falls and Hip Fractures in 22,103 Older Adults Receiving Mental Health Care vs 161,603 Controls: A Large Cohort Study

Risk of Hospitalized Falls and Hip Fractures in 22,103 Older Adults Receiving Mental Health Care vs 161,603 Controls: A Large Cohort Study

The effect of nutrition, depression, activity scores on mortality in patients with geriatric hip fractures.

Antidepressant Drugs and the Risk of Hip Fracture in the Elderly

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