Depression and young age impact on hip fracture subsequent to stroke: A population-based cohort study

Aims: The purpose of this study is to identify whether depression and other associated factors in stroke are related to subsequent hip fracture. Background: There are very few studies that focus on depression and demographic impact on subsequent hip fracture after a stroke. Design: This a retrospective cohort study design. Methods: The Taiwan Longitudinal Health Insurance Database between 1997 and 2010 was used. Two stroke patient cohorts were analysed: (1) depression within 1 year after newly diagnosed strokes; (2) without depression within 1 year after newly diagnosed strokes. Demographic characteristics, comorbidities, and hip fracture were compared using the Fine and Gray regression model for subdistribution hazard ratios. Results/Findings: Patients with depression showed a higher risk of hip fracture (95% CI, 0.99-1.66). Depression was associated with increased risk of hip fracture for patients below 50 years old (95% CI, 1.45-7.34). Comorbidities and gender showed no significant correlation with hip fracture risk in the depressed or nondepressed groups. Conclusion: Poststroke depression was a significant contributor to hip fracture in patients who suffered strokes and had more negative impact on the younger population, regardless of the gender and presence of comorbidities.