A two-year longitudinal study of the impact of cognitive status and depression on frailty status in older adults following hip fracture

Yu-Hua Hsu; Jersey Liang; Ming-Yueh Tseng; Ying-Jen Chen; Yea-Ing L Shyu

doi:10.1016/j.gerinurse.2025.01.021

A two-year longitudinal study of the impact of cognitive status and depression on frailty status in older adults following hip fracture

Geriatr Nurs. 2025 Mar-Apr;62(Pt B):12-18. doi: 10.1016/j.gerinurse.2025.01.021. Epub 2025 Feb 5.

Authors

Yu-Hua Hsu¹, Jersey Liang², Ming-Yueh Tseng³, Ying-Jen Chen⁴, Yea-Ing L Shyu⁵

Affiliations

¹ School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Cardiovascular Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
² Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, United States.
³ Department of Senior Citizen Services, National Tainan Junior College of Nursing, Taiwan.
⁴ Division of Internal Medicine, Department of Internal Medicine, Chang Gung Memorial, Hospital at Linkou, Tao-Yuan, Taiwan.
⁵ School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Dementia Center, Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. Electronic address: yeaing@mail.cgu.edu.tw.

PMID: 39914225
DOI: 10.1016/j.gerinurse.2025.01.021

Abstract

Objectives: To examine if frailty is associated with cognitive status or depression in older adults following surgery for hip fracture.

Design: A 2-year longitudinal correlational cohort study.

Setting and participants: Older adults (≥ 60 years) who had hip-fracture surgery were recruited from a 3,000-bed medical center in Taiwan.

Methods: Participants were recruited between September 2012; follow-up was completed in March 2021. Measures for frailty, cognitive status, and depression were assessed at six points. Frailty changes were analyzed using generalized estimating equations.

Results: Mean age was 78.51 ± 9.0 years. Compared to those without cognitive impairment or without depression, pre-fracture basic activities of daily living (BADLs), baseline walking ability and frailty were worse for participants with cognitive impairment or depression (P < .001). Frailty increased over time for those with cognitive impairment and depression after controlling for covariates (P < .001).

Conclusions: Assessing cognitive status and depression in older adults following hip fracture could guide interventions to reduce frailty.

Keywords: Cognitive function; Depression; Frailty; Hip fracture.

MeSH terms

Activities of Daily Living
Aged
Aged, 80 and over
Cognition*
Cognitive Dysfunction*
Depression* / psychology
Female
Frailty* / psychology
Hip Fractures* / complications
Hip Fractures* / psychology
Hip Fractures* / surgery
Humans
Longitudinal Studies
Male
Middle Aged
Taiwan