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Adapting Acute Medical Rehabilitation as an Intervention for Late-Life Depression After Hip Fracture

Principal Investigator:
Eric Lenze, PhD, PI

Funder:
NIMH R34 

Affiliation:
Center for Mental Health Services Research (CMHSR)

Project Staff:  
Eric Lenze, PhD, PI
Nancy Morrow-Howell, PhD

Project Contact:
Eric Lenze
lenzee@wustl.edu
(314) 362-3903

Project Update as of 09/22/2010

Stage: 
Funded

Description:
Elderly persons who have suffered a disabling medical event, such as a hip fracture, are likely to develop depression.  Late-life depression (LLD) adversely affects acute medical rehabilitation after a hip fracture, increasing the risk for persistent depression and disability.  Existing acute medical rehabilitation settings-skilled nursing facilities (SNFs) and inpatient rehabilitation facilities (IRFs)-do not adequately meet the needs of depressed elders, resulting in a missed opportunity for affective and functional recovery.

This R34 will develop enhanced acute medical rehabilitation for depressed hip fracture patients.  The goal of this enhanced rehabilitative care is to reduce depressive symptoms and improve function.  The intervention will consist of: (1) high intensity PT & OT (2) comprehensive team-based management that incorporates mental health expertise.

In this R34 we will develop enhanced acute medical rehabilitation for depressed hip fracture patients, in three stages: (1) develop a treatment manual (2) pilot and iteratively modify the intervention (3) carry out a preliminary randomized trial of the intervention in a SNF, with usual care comparison.  The R34 is led by a multi-disciplinary team with expertise in rehabilitation research and in mental health interventions in medical settings