A two-year longitudinal study of the impact of cognitive status and depression on frailty status in older adults following hip fracture

Objectives: To examine if frailty is associated with cognitive status or depression in older adults following surgery for hip fracture. Design: A 2-year longitudinal correlational cohort study. Setting and Participants: Older adults (≥ 60 years) who had hip-fracture surgery were recruited from a 3,000-bed medical center in Taiwan. Methods: Participants were recruited between September 2012; follow-up was completed in March 2021. Measures for frailty, cognitive status, and depression were assessed at six points. Frailty changes were analyzed using generalized estimating equations. Results: Mean age was 78.51 ± 9.0 years. Compared to those without cognitive impairment or without depression, pre-fracture basic activities of daily living (BADLs), baseline walking ability and frailty were worse for participants with cognitive impairment or depression (P < .001). Frailty increased over time for those with cognitive impairment and depression after controlling for covariates (P < .001). Conclusions: Assessing cognitive status and depression in older adults following hip fracture could guide interventions to reduce frailty.