Depression, Dementia and Delirium in Older Adults Presenting with Hip Fractures to Orthopaedic Services at a General Hospital

Abstract

Aim: A survey to address psychiatric morbidity in older adults admitted with hip fracture, involvement of liaison psychiatric services for older adults and evaluate change of level of care.Methods: Information about mental and physical health prior to and during admission, referrals to Geriatrician or Liaison Old Age Psychiatry (LOAP) team, duration of hospital stay and level of care was collected for 43 consecutive admissions of older adults for hip fracture over 6 months period.Results: Depression, dementia and delirium were present in 28%, 42% and 23% patients respectively. A pre admission diagnosis of depression was associated with lower Barthel scores on admission, whereas dementia and delirium with lower Barthel scores on both admission and at 48 hours post surgery. Pre admission diagnosis of depression or dementia and the occurrence of delirium did not affect the duration of stay in the orthopaedic ward or alter the level of care after discharge. Conclusions:There are high rates of psychiatric morbidity in older adults presenting with hip fracture to orthopaedic services. Active involvement of the LOAP team would facilitate their prompt identification and treatment post fracture and improve outcomes for these patients.