Predictors of Posttraumatic Stress Symptoms and Association with Fear of Falling After Hip Fracture

Objectives: To determine whether fall-related hip fracture, alone or in the presence of Fear of Falling, is likely to induce PTSD in an elderly population.

Design: A longitudinal prospective study of patients admitted for hip fracture.

Setting: Eight St. Louis, Missouri, area hospitals.

Participants: Individuals aged 60 and older admitted for surgical hip fracture repair after a fall (N = 456).

Measurements: Rates of partial and full posttraumatic stress disorder (pPTSD and fPTSD) were compared with rates of FoF. PTSD and FoF were assessed 4 and 12 weeks after surgery. Baseline characteristics including depression, stress, pain, cognitive functioning, and anesthesia type were also analyzed as potential predictors of PTSD symptoms 12 weeks after surgery.

Results: No participants met criteria for fPTSD at 4 or 12 weeks, and rates of pPTSD were low 12 weeks after surgery (7.4%), in contrast to high rates of FoF symptoms at the same time point (58.5%). Higher ratings of stress and depressive symptoms at baseline were associated with higher levels of PTSD symptoms 12 weeks after surgery.

Conclusions: Hip fracture, despite its considerable morbidity, does not induce fPTSD and infrequently induces pPTSD. Individuals with higher rates of stress and depressive symptoms after hip fracture repair may be more likely to develop PTSD symptoms.