Depression following hip fracture is associated with increased physical frailty in older adults : the role of the cortisol: dehydroepiandrosterone sulphate ratio

Research output: Contribution to journalArticlepeer-review

Standard

Harvard

APA

Vancouver

Author

Bibtex

@article{254c9a5dd49d46fba592254e43e32342,
title = "Depression following hip fracture is associated with increased physical frailty in older adults : the role of the cortisol: dehydroepiandrosterone sulphate ratio",
abstract = "BackgroundHip fracture in older adults is associated with depression and frailty. This study examined the synergistic effects of depression and hip fracture on physical frailty, and the mediating role of the cortisol:dehydroepiandrosterone sulphate (DHEAS) ratio.MethodsThis was an observational longitudinal study of patients with a hip fracture carried out in a hospital setting and with follow up in the community.Participants were 101 patients aged 60+ years (81 female) with a fractured neck of femur.Measurements of the ability to carry out activities of daily living (ADL), cognitive function, physical frailty and assays for serum cortisol and DHEAS were performed six weeks and six months post-hip fracture. Depressed and non-depressed groups were compared by ANOVA at each time point.ResultsHip fracture patients who developed depression by week six (n = 38) had significantly poorer scores on ADL and walking indices of frailty at both week six and month six, and poorer balance at week six. The association with slower walking speed was mediated by a higher cortisol:DHEAS ratio in the depressed group.ConclusionDepression following hip fracture is associated with greater physical frailty and poorer long term recovery post-injury. Our data indicate that the underlying mechanisms may include an increased cortisol:DHEAS ratio and suggest that correcting this ratio for example with DHEA supplementation could benefit this patient population.",
keywords = "Depression, Hip fracture, Frailty, Cortisol, Dehydroepiandrosterone sulphate",
author = "Phillips, {Anna C} and Jane Upton and Niharika Duggal and Douglas Carroll and Lord, {Janet M}",
year = "2013",
month = jun,
day = "17",
doi = "10.1186/1471-2318-13-60",
language = "English",
volume = "13",
journal = "BMC Geriatrics",
issn = "1471-2318",
publisher = "Springer",
number = "1",

}

RIS

TY - JOUR

T1 - Depression following hip fracture is associated with increased physical frailty in older adults : the role of the cortisol: dehydroepiandrosterone sulphate ratio

AU - Phillips, Anna C

AU - Upton, Jane

AU - Duggal, Niharika

AU - Carroll, Douglas

AU - Lord, Janet M

PY - 2013/6/17

Y1 - 2013/6/17

N2 - BackgroundHip fracture in older adults is associated with depression and frailty. This study examined the synergistic effects of depression and hip fracture on physical frailty, and the mediating role of the cortisol:dehydroepiandrosterone sulphate (DHEAS) ratio.MethodsThis was an observational longitudinal study of patients with a hip fracture carried out in a hospital setting and with follow up in the community.Participants were 101 patients aged 60+ years (81 female) with a fractured neck of femur.Measurements of the ability to carry out activities of daily living (ADL), cognitive function, physical frailty and assays for serum cortisol and DHEAS were performed six weeks and six months post-hip fracture. Depressed and non-depressed groups were compared by ANOVA at each time point.ResultsHip fracture patients who developed depression by week six (n = 38) had significantly poorer scores on ADL and walking indices of frailty at both week six and month six, and poorer balance at week six. The association with slower walking speed was mediated by a higher cortisol:DHEAS ratio in the depressed group.ConclusionDepression following hip fracture is associated with greater physical frailty and poorer long term recovery post-injury. Our data indicate that the underlying mechanisms may include an increased cortisol:DHEAS ratio and suggest that correcting this ratio for example with DHEA supplementation could benefit this patient population.

AB - BackgroundHip fracture in older adults is associated with depression and frailty. This study examined the synergistic effects of depression and hip fracture on physical frailty, and the mediating role of the cortisol:dehydroepiandrosterone sulphate (DHEAS) ratio.MethodsThis was an observational longitudinal study of patients with a hip fracture carried out in a hospital setting and with follow up in the community.Participants were 101 patients aged 60+ years (81 female) with a fractured neck of femur.Measurements of the ability to carry out activities of daily living (ADL), cognitive function, physical frailty and assays for serum cortisol and DHEAS were performed six weeks and six months post-hip fracture. Depressed and non-depressed groups were compared by ANOVA at each time point.ResultsHip fracture patients who developed depression by week six (n = 38) had significantly poorer scores on ADL and walking indices of frailty at both week six and month six, and poorer balance at week six. The association with slower walking speed was mediated by a higher cortisol:DHEAS ratio in the depressed group.ConclusionDepression following hip fracture is associated with greater physical frailty and poorer long term recovery post-injury. Our data indicate that the underlying mechanisms may include an increased cortisol:DHEAS ratio and suggest that correcting this ratio for example with DHEA supplementation could benefit this patient population.

KW - Depression

KW - Hip fracture

KW - Frailty

KW - Cortisol

KW - Dehydroepiandrosterone sulphate

U2 - 10.1186/1471-2318-13-60

DO - 10.1186/1471-2318-13-60

M3 - Article

C2 - 23773910

VL - 13

JO - BMC Geriatrics

JF - BMC Geriatrics

SN - 1471-2318

IS - 1

M1 - 60

ER -