TRAJECTORIES OF DEPRESSIVE SYMPTOMS AMONG OLDER ADULTS AND IN ADULTS WITH HIP FRACTURE: ANALYSIS FROM ENGLISH LONGITUDINAL STUDY OF AGEING

R. Milton-Cole¹, S. Ayis¹, M.D.L. O'Connell¹, T. Smith², K. Sheehan¹

¹King's College London, London, United Kingdom, ²University of East Anglia, Norwich, United Kingdom

Background: Late life depression is the term used for depression symptomology experienced by older adults. Unanticipated healthcare events such as hip fracture may negatively influence trajectories of depressive symptoms in older adults and therefore, investigating if trajectories differ between the general older adult population and those with hip fracture beyond 1-year post-fracture would offer additional understanding of the role of hip fracture in depressive symptoms over time.

Purpose: This study aimed to determine trajectories of depressive symptoms among older adults in England, overall and for those after hip fracture, and identify characteristics defining trajectory membership.

Methods: Analysis of adults aged 60 years or more (n=7,050), including a hip fracture subgroup (n = 384), from the English Longitudinal Study of Ageing. Latent class growth mixture modelling was completed. Depressive symptom prevalence was estimated at baseline. Chi-squared tests were completed to compare baseline characteristics across trajectories.

Results: Three trajectories of depressive symptoms (no, mild, and moderate-severe) were identified overall and for those with hip fracture. The moderate-severe trajectory comprised 13.7% and 7% of participants for overall and hip fracture populations, respectively. The proportion of participants with depressive symptoms in the moderate-severe trajectory was 65.4% and 85.2% for overall and hip fracture populations, respectively. Depressive symptoms were stable over time, with a weak trend towards increasing severity for the moderate-severe symptom trajectory. Participants in the moderate-severe symptom trajectory were older, more likely to be female, live alone and had worse health measures than other trajectories (p < 0.001).

Conclusions: Older adults, and those with hip fracture, follow one of three trajectories of depressive symptoms which are broadly stable over time. Depressive symptoms’ prevalence was higher for those with hip fracture and, when present, the symptoms were more severe than the overall population. Results suggest a role of factors including age, gender, and marital status in depressive symptoms trajectories.

Implications: The three trajectories which are broadly stable over time may suggest it is never too late to target depressive symptoms for patients as symptoms may persist in the long term. Results suggest a role of factors including age, gender, and marital status in trajectories of depressive symptoms both overall and for those with hip fracture which should be explored in future research.

Funding acknowledgements: This work forms part of a PhD studentship, funded as host contribution to UKRI Future Leaders Fellowship (Grant Ref: MR/S032819/1)

Keywords:
Depressive symptoms
Depression
Hip fracture

Topics:
Older people
Musculoskeletal: lower limb
Mental health

Did this work require ethics approval? No

Reason: This work was a secondary analysis of a published dataset freely available for download online through the UK Data service