Cargando…

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

BACKGROUND: Hip 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. METHODS: This was an observational...

Descripción completa

Detalles Bibliográficos
Autores principales: Phillips, Anna C, Upton, Jane, Duggal, Niharika Arora, Carroll, Douglas, Lord, Janet M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3698022/
https://www.ncbi.nlm.nih.gov/pubmed/23773910
http://dx.doi.org/10.1186/1471-2318-13-60
_version_ 1782275225728057344
author Phillips, Anna C
Upton, Jane
Duggal, Niharika Arora
Carroll, Douglas
Lord, Janet M
author_facet Phillips, Anna C
Upton, Jane
Duggal, Niharika Arora
Carroll, Douglas
Lord, Janet M
author_sort Phillips, Anna C
collection PubMed
description BACKGROUND: Hip 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. METHODS: This 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. RESULTS: Hip 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. CONCLUSION: Depression 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.
format Online
Article
Text
id pubmed-3698022
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-36980222013-07-02 Depression following hip fracture is associated with increased physical frailty in older adults: the role of the cortisol: dehydroepiandrosterone sulphate ratio Phillips, Anna C Upton, Jane Duggal, Niharika Arora Carroll, Douglas Lord, Janet M BMC Geriatr Research Article BACKGROUND: Hip 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. METHODS: This 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. RESULTS: Hip 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. CONCLUSION: Depression 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. BioMed Central 2013-06-17 /pmc/articles/PMC3698022/ /pubmed/23773910 http://dx.doi.org/10.1186/1471-2318-13-60 Text en Copyright © 2013 Phillips et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Phillips, Anna C
Upton, Jane
Duggal, Niharika Arora
Carroll, Douglas
Lord, Janet M
Depression following hip fracture is associated with increased physical frailty in older adults: the role of the cortisol: dehydroepiandrosterone sulphate ratio
title Depression following hip fracture is associated with increased physical frailty in older adults: the role of the cortisol: dehydroepiandrosterone sulphate ratio
title_full Depression following hip fracture is associated with increased physical frailty in older adults: the role of the cortisol: dehydroepiandrosterone sulphate ratio
title_fullStr Depression following hip fracture is associated with increased physical frailty in older adults: the role of the cortisol: dehydroepiandrosterone sulphate ratio
title_full_unstemmed Depression following hip fracture is associated with increased physical frailty in older adults: the role of the cortisol: dehydroepiandrosterone sulphate ratio
title_short Depression following hip fracture is associated with increased physical frailty in older adults: the role of the cortisol: dehydroepiandrosterone sulphate ratio
title_sort depression following hip fracture is associated with increased physical frailty in older adults: the role of the cortisol: dehydroepiandrosterone sulphate ratio
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3698022/
https://www.ncbi.nlm.nih.gov/pubmed/23773910
http://dx.doi.org/10.1186/1471-2318-13-60
work_keys_str_mv AT phillipsannac depressionfollowinghipfractureisassociatedwithincreasedphysicalfrailtyinolderadultstheroleofthecortisoldehydroepiandrosteronesulphateratio
AT uptonjane depressionfollowinghipfractureisassociatedwithincreasedphysicalfrailtyinolderadultstheroleofthecortisoldehydroepiandrosteronesulphateratio
AT duggalniharikaarora depressionfollowinghipfractureisassociatedwithincreasedphysicalfrailtyinolderadultstheroleofthecortisoldehydroepiandrosteronesulphateratio
AT carrolldouglas depressionfollowinghipfractureisassociatedwithincreasedphysicalfrailtyinolderadultstheroleofthecortisoldehydroepiandrosteronesulphateratio
AT lordjanetm depressionfollowinghipfractureisassociatedwithincreasedphysicalfrailtyinolderadultstheroleofthecortisoldehydroepiandrosteronesulphateratio