Journals of Gerontology Series A: Biological Sciences and Medical Sciences, Vol 54, Issue 12 M607-M612, Copyright © 1999 by The Gerontological Society of America
Geropsychological problems in medical rehabilitation: dementia and depression among stroke and lower extremity fracture patients
BT Mast, SE MacNeill and PA Lichtenberg
Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, Michigan 48202, USA. [email protected]
BACKGROUND: Although stroke and lower extremity fracture are often viewed
as distinct medical rehabilitation conditions, they share similarities in
that they are both experienced primarily among older adults, and are often
accompanied by gero-psychological problems such as dementia and depression.
In spite of these similarities, actual comparisons of these prevalence
rates have been rare in the previous literature, most likely due to obvious
differences in the nature of the injuries involved (neurological vs.
peripheral injury). METHODS: One hundred and one stroke and 198 lower
extremity fracture patients were assessed with neuropsychological tests
from the Normative Studies Research Project test battery. The prevalence
rates of dementia and depression were then compared between these two
patient groups. RESULTS: Overall, 34.7% of stroke and 27.8% of lower
extremity fracture patients met the criteria for dementia. In addition,
33.3% of stroke and 25.1% of lower extremity fracture patients scored in
the depressed range on the Geriatric Depression Scale. The prevalence rates
for dementia and depression did not differ significantly between these two
patient groups. CONCLUSIONS: Although rehabilitation efforts focus mainly
upon the primary diagnoses of geriatric patients, these findings suggest
that stroke and lower extremity fracture should be considered within the
context of the geriatric issues (e.g., dementia, depression, and comorbid
medical illness) which accompany them.
