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Age and Ageing 2000; 29: 537-546
© 2000, British Geriatrics Society

Systematic review

Psychiatric illness in hip fracture

John D. Holmes and Allan O. House

Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, 15 Hyde Terrace, Leeds LS2 9LT, UK

Abstract

Objective: to review the literature on the prevalence and effect on outcome of psychiatric illness in older people with hip fracture.

Methods: searching of medical databases and bibliographies to identify relevant studies. Application of predetermined quality criteria for prevalence and outcome studies.

Results: 19 studies met criteria for a prevalence study. Rates of psychiatric illness varied, with depression in 9–47%, delirium in 43–61% and unspecified cognitive impairment in 31–88%. Four studies met criteria for an outcome study. Psychiatric illness resulted in increased mortality and dependence and decreased activities of daily living skills. No individual study examined the prevalences and effect on outcome of depression, delirium and dementia separately.

Conclusions: depression, delirium and dementia are common in older people with hip fracture. Further research is required to examine the effect on outcome of psychiatric illness, and the effect of psychiatric interventions in this setting.

Keywords: cognitive impairment, dementia, delirium, hip fracture, psychiatric illness


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