Depressive Symptoms Can Attenuate Rehabilitation Effects in Fracture Patients.

Objectives: This study aimed to clarify the relationship between depressive symptoms on admission and improvement in activities of daily living (ADLs) among patients with fractures admitted to a recovery rehabilitation unit.

Methods: This retrospective observational study enrolled patients with fractures who were admitted to a rehabilitation hospital between August 2018 and October 2020 in Okinawa City, Japan. Based on Geriatric Depression Scale scores, patients were divided into two groups: one group with depressive symptoms and another group without depressive symptoms. Associations between depressive symptoms and the motor Functional Independence Measure (FIM) gain were identified using multivariate linear regression analyses.

Results: Out of 127 patients (range, 40.0-83.0 years; male: 27.6%), 71 had depressive symptoms on admission. Multiple linear regression analysis revealed that depressive symptoms on admission were significantly associated with motor FIM gain (β coefficient: -5.022, 95% confidence interval -9.551 to -0.494, P = 0.030). Body Mass Index on admission, motor FIM on admission, Mini-Mental State Examination on admission, and use of antidepressants were also associated with motor FIM gain.

Conclusions: Among patients with fractures admitted to a recovery rehabilitation unit, depressive symptoms on admission were associated with less improvement in ADLs. The use of antidepressants was also an independent factor affecting the improvement of ADLs in these patients.