Psychiatric illness in hip fracture

Objective: to review the literature on the prevalence and effect on outcome of psychiatric illness in older people with hip fracture. Methods: searching of medical databases and bibliographies to identify rele vant studies. Application of predetermined quality criteria for prevalence and outcome studies. Results: 19 studies met criteria for a prevalence study. Rates of psychiatr ic illness varied, with depression in 9-47%, delirium in 43-61% and unspeci fied cognitive impairment in 31-88%. Four studies met criteria for an outco me study. Psychiatric illness resulted in increased mortality and dependenc e and decreased activities of daily living skills. No individual study exam ined the prevalences and effect on outcome of depression, delirium and deme ntia separately. Conclusions: depression, delirium and dementia are common in older people w ith hip fracture. Further research is required to examine the effect on out come of psychiatric illness, and the effect of psychiatric interventions in this setting.