The effectiveness of psychological interventions for older adults with hip fractures: A systematic review and meta-analysis

Abstract

This study systematically assessed the effectiveness of theory-based psychological interventions on psychosocial outcomes and physical function in older adults with hip fractures. We searched six English and three Chinese databases, grey literature, and reference lists for records up to January 2025, identifying randomised controlled trials (RCTs) or controlled clinical trials (CCTs) reporting relevant outcomes (e.g. anxiety, depression, and hip joint function). Meta-analysis was performed when feasible; otherwise, narrative synthesis was used. Sixteen studies (n = 1558) were included, with 13 suitable for meta-analysis. The results indicated that psychological interventions were associated with improvements in psychosocial outcomes, although no statistically significant effect was observed on physical function. Subgroup analysis suggested that patients aged ≤ 70 years may experience greater improvement in anxiety, whereas those older than 70 showed a more pronounced trend in depression reduction. Mindfulness-based interventions also demonstrated potential for alleviating symptoms of anxiety and depression. However, due to methodological limitations and the risk of bias in the included studies, the current evidence requires further validation to strengthen its validity. Future research should prioritise high-quality RCTs with clearly defined intervention durations, adopt multimodal intervention approaches, and enhance the assessment of physical function and clinically relevant outcomes to accumulate more robust evidence.