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This chapter discusses the impact of hip fracture in older age and in particular factors affecting recovery of physical function and wellbeing. It focuses particularly on a study of the impact of depression following hip fracture in older adults, and the influence of this depression on a range of outcomes including immune function, stress hormones, illness perceptions, physical function, and length of stay in health service and rehabilitation facilities. It shows that depression is common following hip fracture among older people, and is the biggest predictor of a slower recovery and poorer function in terms of immunity, wellbeing and physical ability. A pilot study associated with this research showed that illness perceptions following hip fracture did not differ between UK and Punjabi older adults, but that Punjabi speakers in India had greater levels of distress. Implications for health service policy and practice resulting from this research are discussed in this chapter, including potential intervention strategies to improve outcomes after hip fracture.
This chapter discusses the various aspects of health and well-being in later life that were studied by fourteen different NDA projects. The first part of this chapter examines some of the key concepts in this field, including quality of life and subjective well-being. It focuses on the barriers to healthy ageing and good quality of life in old age. These include economic barriers, physiological effects, limits to mobility, barriers to paid employment, and psychosocial barriers. The second half of the chapter looks at interventions to support well-being and healthy ageing. Drawing on the extensive testing of models by the NDA projects, the chapter focuses on six different types of intervention: financial, pharmacological, physical (exercise), environmental (blue light and OWL), community music making, and engagement with art.
