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Fear of falling more important than pain and depression for functional recovery after surgery for hip fracture in older people.

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Title: Fear of falling more important than pain and depression for functional recovery after surgery for hip fracture in older people.
Authors: Oude Voshaar RC (AUTHOR), Banerjee S (AUTHOR), Horan M (AUTHOR), Baldwin R (AUTHOR), Pendleton N (AUTHOR), Proctor R (AUTHOR), Tarrier N (AUTHOR), Woodward Y (AUTHOR), Burns A (AUTHOR)
Source: Psychological Medicine. Nov2006, Vol. 36 Issue 11, p1635-1645. 11p.
Abstract: Background. Depression and cognitive functioning have a negative impact on functional recovery after hip fracture surgery in older people, and the same has been suggested for pain and fear of falling. These variables, however, have never been studied together, nor has the timing of psychiatric assessment been taken into account.Method. Two parallel, randomized controlled trials were undertaken aiming to prevent and treat depression after hip fracture surgery in older people. Multiple logistic regression analyses corrected for age and pre-morbid level of functioning were performed to evaluate the effect of depressive symptoms (15-item Geriatric Depression Scale, GDS), pain (Wong-Baker pain scale), cognitive functioning (Mini-mental State Examination, MMSE) and fear of falling (Modified Falls Efficacy Scale, MFES) within 2 weeks after surgery and 6 weeks later on functional recovery at 6 months. Main outcome measures were performance-based measures (up-and-go test, gait test, functional reach) and the self-report Sickness Impact Profile (SIP) questionnaire to assess the impact of the hip fracture on activities of daily living (ADL).Results. Two hundred and ninety-one patients participated and outcome measures for 187 (64%) patients were available at 6 months. All mental health variables interfered with functional recovery. However, in the final multivariate model, cognitive functioning and fear of falling assessed 6 weeks after surgery consistently predicted functional recovery, whereas pain and depressive symptoms were no longer significant.Conclusion. Fear of falling and cognitive functioning may be more important than pain and depression to predict functional recovery after hip fracture surgery. Rehabilitation strategies should take this into account. [ABSTRACT FROM AUTHOR]
Copyright of Psychological Medicine is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Fear of falling more important than pain and depression for functional recovery after surgery for hip fracture in older people.
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  Data: <searchLink fieldCode="AR" term="%22Oude+Voshaar+RC%22">Oude Voshaar RC</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Banerjee+S%22">Banerjee S</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Horan+M%22">Horan M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Baldwin+R%22">Baldwin R</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pendleton+N%22">Pendleton N</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Proctor+R%22">Proctor R</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tarrier+N%22">Tarrier N</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Woodward+Y%22">Woodward Y</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Burns+A%22">Burns A</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Psychological+Medicine%22">Psychological Medicine</searchLink>. Nov2006, Vol. 36 Issue 11, p1635-1645. 11p.
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background. Depression and cognitive functioning have a negative impact on functional recovery after hip fracture surgery in older people, and the same has been suggested for pain and fear of falling. These variables, however, have never been studied together, nor has the timing of psychiatric assessment been taken into account.Method. Two parallel, randomized controlled trials were undertaken aiming to prevent and treat depression after hip fracture surgery in older people. Multiple logistic regression analyses corrected for age and pre-morbid level of functioning were performed to evaluate the effect of depressive symptoms (15-item Geriatric Depression Scale, GDS), pain (Wong-Baker pain scale), cognitive functioning (Mini-mental State Examination, MMSE) and fear of falling (Modified Falls Efficacy Scale, MFES) within 2 weeks after surgery and 6 weeks later on functional recovery at 6 months. Main outcome measures were performance-based measures (up-and-go test, gait test, functional reach) and the self-report Sickness Impact Profile (SIP) questionnaire to assess the impact of the hip fracture on activities of daily living (ADL).Results. Two hundred and ninety-one patients participated and outcome measures for 187 (64%) patients were available at 6 months. All mental health variables interfered with functional recovery. However, in the final multivariate model, cognitive functioning and fear of falling assessed 6 weeks after surgery consistently predicted functional recovery, whereas pain and depressive symptoms were no longer significant.Conclusion. Fear of falling and cognitive functioning may be more important than pain and depression to predict functional recovery after hip fracture surgery. Rehabilitation strategies should take this into account. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Psychological Medicine is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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