DEPRESSIVE SYMPTOM SUBTYPES IN OLDER ADULTS AFTER HIP FRACTURE. (11th November 2018)

• Record Type: Journal Article
• Authors: Rathbun, A; Gallo, J; Stuart, E; Shardell, M; Gruber-Baldini, A; Orwig, D; Ryan, A; Magaziner, J
• Is Part Of: Innovation in aging. Volume 2(2018)Supplement 1
• Page Start: 510
• Page End: 510
• Publication Date: 2018-11-11
• Subjects: Aging -- Periodicals; Gerontology -- Periodicals; 612.67
• DOI: 10.1093/geroni/igy023.1893
• Languages: English
• ISSNs: 2399-5300

Abstract

Abstract: Depressive symptoms after hip fracture are common, and psychosocial impairment impedes recovery. However, depression is clinically heterogenous; thus, the aim was to identify and describe depressive symptom subtypes in the year following hip fracture. Men (n=149) and women (n=155) 65 years or older from the Baltimore Hip Studies 7th Cohort with depressive symptoms measured at baseline (within 22 days post-admission) or 2, 6, or 12 months follow-up using the 20-item Center for Epidemiological Studies Depression (CES-D) scale were included (n=304). Longitudinal latent class analysis was applied to participant's CES-D symptoms to identify subtypes with similar patterns of depressive symptoms during the yearlong hip fracture recovery period. Item-response probabilities were used to evaluate the symptomatic profiles for each subtype. Posterior probability estimates were used to assign time-specific subtype membership and describe changes in prevalence. Four depression subtypes were identified: "No Symptoms" (49.3%), "Moderate-Melancholic" (31.3%), "Severe-Melancholic" (12.0%), and "Severe-Anhedonic" (7.4%). "No Symptoms" had low item-response probabilities across all symptoms and increased in prevalence during recovery. "Moderate-Melancholic" and "Severe-Melancholic" were differentiated by higher item-response probabilities for symptoms of anhedonia, somatic criterion, and psychomotor agitation but prevalence for both groups decreased over time. "Severe-Anhedonic" had greater item-response probabilities for the inability to experience pleasure and prevalence remained constant. Findings revealed four distinct depressive symptom subtypes in older adults after hip fracture, which differ in prevalence and clinical presentation, and severe subtypes may be risk factors for poor recovery and require specific intervention.