Correlation between depression and the risk of hip fracture in the middle-aged and elderly population in the Chinese community
10.3760/cma.j.cn121113-20230922-00194
- VernacularTitle:中国社区中老年人群抑郁症与髋部骨折风险的相关性研究
- Author:
Haoze HU
1
;
Qixing LIANG
;
Xinzhi MA
;
Yuwangxuan QIAN
;
Huiyu HU
;
Xueqin HU
Author Information
1. 浙江中医药大学第三临床医学院，杭州 310053
- Keywords:
Hip joint;
Fractures, bone;
Depressive disorder;
Risk factors
- From:
Chinese Journal of Orthopaedics
2024;44(15):1002-1009
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyse the correlation between depression and hip fracture in the middle-aged and elderly population in the Chinese community.Methods:The study data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) database. A total of 16,831 respondents from 12,400 households in the fourth national follow-up data in 2018 were selected as the research sample. The samples were divided into a training set and a test set at a ratio of 7∶3, and the test set data were used for internal validation. For external validation, 2,337 subjects recruited from the Institute of Orthopaedics, the First Affiliated Hospital of Zhejiang Chinese Medical University from 2018 to 2023 were selected as the survey subjects. The Center for Epidemiological Studies Depression Scale (CESD) was used to assess depression. CESD≥16 points were defined as depression, and CESD<16 points were defined as no depression. Binary logistic regression was used to gradually analyze the correlation between depression and hip fracture after adjusting for different covariates.Results:In the training set, statistically significant differences were observed between patients with and without hip fractures in terms of depression prevalence (χ 2=16.310, P<0.001), age (χ 2=9.417, P=0.009), education level ( P<0.001), marital status ( P=0.019), and place of residence ( P=0.035). In the testing set, statistically significant differences were found in depression prevalence (χ 2=10.130, P=0.001), gender (χ 2=4.368, P=0.037), education level ( P=0.013), and smoking history (χ 2=8.804, P=0.012). In the external validation set, significant differences were noted in depression prevalence (χ 2=337.885, P<0.001), age (χ 2=29.475, P<0.001), and smoking history ( P=0.020). After controlling for demographic characteristics, exercise, smoking and drinking history, binary logistic regression showed that the risk of hip fracture in depressed patients was 1.78 times higher in the training set ( OR=1.78, P<0.001), 2.73 times higher in the testing set ( OR=2.73, P=0.002), and 15.21 times higher in the external validation set ( OR=15.21, P<0.001) than that of non-depressed patients, indicating good internal and external validation results. Conclusion:Depression is an independent risk factor for hip fractures among middle-aged and elderly populations in Chinese communities. Early identification and active intervention for depression in this population can help reduce the risk of hip fractures.
