Mental Disorders in Elderly Patients with Fracture of the Femoral Neck or the Femur

Abstract

The aim of the investigation was to study prevalence rate and the diagnostic distribution of mental disorders in the elderly patients, hospitalized due to the fracture of the femoral neck or the femur and to determine the prognosis of the disease course. We included in this study 101 patients aged 60 years and over with a femoral neck fracture (49 persons) or the proximal femur fracture (52 persons), who was hospitalized in trauma departments of the 2 Clinical Hospitals in Moscow. There were 73 women and 28 men (in the ratio 1:2,6), the mean age in the group was 76,4 + 8.2 years. The analysis of the examined cohort of patients showed that 82.2% of them at the time of the study had various mental disorders. The fracture of the femoral neck or the femur can be viewed as provocative or etiological factors of such mental disorders as confusion (19,8%), situational depression (8,9%), sleep disorders (5,9%), alcohol delirium (3%). These mental disorders have been found more than a third of the survey population (37.6 %). The depressive spectrum disorders occurred more frequently in younger persons, while the confusion was more frequently among older persons. The data of one-year-follow up study revealed that 27.8 % of examinated patients died. The research confirmed the expected high frequency of the adverse outcomes of fracture of the femur or the femoral neck in elderly and senile patients with confusion or dementia. The probability of reduction of mental disorders after these fractures greatly increases after early surgical treatment.