Psychiatric illness in hip fracture.

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.