Objective to evaluate patterns of depressive symptoms after hip fracture and examine their impact on functional recovery. Methods participants (n = 304) included older adults from the Baltimore Hip Studies 7th cohort who experienced a hip fracture. Depressive symptoms were measured at baseline or 2-, 6- or 12-month post-hip fracture using the 20-item Center for Epidemiologic Studies Depression scale. Gait speed was measured after hip fracture at 2-, 6- or 12-month follow-up. Latent class analysis was used to identify individuals with similar patterns of depressive symptoms after hip fracture. Item response probabilities characterised symptom profiles, and posterior probability estimates were used to assign participants to a baseline depressive symptom subtype. Weighted estimated equations compared post-fracture gait speed between baseline symptomatic and asymptomatic groups. Results four patterns of depressive symptoms were identified: asymptomatic (50.8%), somatic (28.6%), melancholic (11.4%) and anhedonic (9.2%). The somatic subtype was characterised by difficultly concentrating and reduced energy and movement, whereas anhedonic symptoms were associated with the inability to experience pleasure. Melancholic symptoms corresponded to anhedonia, decreased physical activity and other psychological and somatic complaints. Compared with the asymptomatic group, somatic symptoms were consistently associated with slower gait speed, −0.03 metres per second (m/s) and between-group differences for melancholic symptomology were as large as −0.05 m/s, but the associations were not statistically significant. Conclusion findings demonstrate unique depressive symptom subtypes in older adults after hip fracture and provide confirmatory evidence of unique clinical phenotypes; however, their impact on functional recovery after hip fracture remains unclear.

中文翻译：

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髋部骨折后老年人抑郁症状的异质性

目的评估髋部骨折后抑郁症状的模式并检查其对功能恢复的影响。方法参与者 (n = 304) 包括来自巴尔的摩髋关节研究第 7 队列的曾经历过髋部骨折的老年人。使用包含 20 项的流行病学研究中心抑郁量表在基线或髋部骨折后 2、6 或 12 个月时测量抑郁症状。在髋部骨折后 2、6 或 12 个月的随访中测量步态速度。潜在类别分析用于识别髋部骨折后具有相似抑郁症状模式的个体。项目反应概率表征了症状特征，后验概率估计用于将参与者分配到基线抑郁症状亚型。加权估计方程比较了基线有症状组和无症状组之间的骨折后步态速度。结果确定了四种抑郁症状模式：无症状（50.8%）、躯体症状（28.6%）、忧郁型（11.4%）和快感缺乏型（9.2%）。躯体亚型的特点是难以集中注意力、精力和运动减少，而快感缺乏症状则与无法体验快乐有关。忧郁症状与快感缺失、体力活动减少以及其他心理和躯体症状相对应。与无症状组相比，躯体症状始终与较慢的步态速度相关，-0.03米/秒（m/s），组间忧郁症状差异高达-0.05 m/s，但这种关联没有统计学意义重要的。结论研究结果表明老年人髋部骨折后存在独特的抑郁症状亚型，并为独特的临床表型提供了确凿的证据；然而，它们对髋部骨折后功能恢复的影响仍不清楚。