• Ka Keat Lim, David B Matchar, Chuen Seng Tan, William Yeo, Truls Østbye, Tet Sen Howe, and KohJoyce S BJSBDepartment of Orthopaedic Surgery, Singapore General Hospital, Singapore; Duke-NUS Medical School, Singapore..
• Programme in Health Services & Systems Research, Duke-NUS Medical School, Singapore. Electronic address: limkk@u.duke.nus.edu.
• J Am Med Dir Assoc. 2020 Feb 1; 21 (2): 260-266.e2.

ObjectivesTo examine the associations of prefracture psychological resilience and prefracture general mental health with physical function among older adults with hip fracture surgery.DesignSingle-center observational study.InterventionNone.Setting And ParticipantsPatients aged ≥50 years who underwent first hip fracture surgery between January 2017 and December 2017 (N = 152).MethodsWe used data collected prospectively from the hospital's hip fracture registry. We performed generalized estimating equations to examine the associations of prefracture psychological resilience (10-item Connor-Davidson Resilience Scale) and prefracture general mental health (Short Form-36 mental health subscale) with physical function (Short Form-36 physical functioning subscale) at 4 time points-prefracture (based on recall), and 1.5, 3, and 6 months after surgery.ResultsPrefracture psychological resilience had an association with physical function; a 1-unit increase in psychological resilience score was associated with 1.15 units [95% confidence interval (CI) 0.71, 1.59] higher physical function score across 4 time points. In contrast, the association between general mental health and physical function varied over time; a 1-unit increase in general mental health score was associated with 0.42 units (95% CI 0.18, 0.66) higher physical function score at prefracture, 0.02 units (95% CI -0.18, 0.22) lower at 1.5 months, 0.23 units (95% CI -0.03, 0.49) higher at 3 months, and 0.39 units (95% CI 0.09, 0.68) higher at 6 months after surgery.Conclusions And ImplicationsPsychological resilience is associated with physical function among older adults with hip fracture surgery, independent from general mental health. Our findings suggest the potential for interventions targeting psychological resilience for these patients and call for more studies on psychological factors affecting physical function recovery after hip fracture surgery.Copyright © 2019 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

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