3598 Resilience mediates the relationship between baseline health and functional recovery in older patients following hip fracture

Abstract Introduction Hip fractures in older adults often lead to prolonged disability and reduced quality of life. While baseline physical health is a known predictor of recovery following hip fracture, the underlying causal mechanisms remain poorly understood. There is growing interest in the influence psychosocial factors—for example, psychological resilience—have on recovery. This study examines the relationship between baseline psychological resilience and 12-month recovery of functional outcomes following hip fracture surgery in older patients. Methods A 12-month, multi-centre pilot cohort study was conducted with 125 adults aged ≥50 years, hospitalised for hip fracture. A final analytical sample of 86 participants (mean age 72.5 years) was analysed for longitudinal outcomes. Baseline psychological resilience (measured by CD-RISC10) and physical health (handgrip strength) were assessed during acute hospitalisation. The primary outcome was functional outcomes at 12-months, measured using the Modified Barthel Index, Parker Mobility Score and SF-36 Questionnaire (Physical Function). Mixed-effects regression models evaluated the association between baseline resilience and functional recovery over time. Causal mediation analysis was performed to assess whether resilience mediated the effect of baseline physical function on recovery. Results Resilience was directly associated with improved physical function in the 12 months following hip fracture surgery. Resilience partially mediated the relationship between baseline physical health and recovery of mobility, and recovery of self-rated physical health. Respectively, resilience mediated 22.5% of the total effect between baseline physical health and mobility after 12-months, and 23.6% of the total effect between baseline physical health and self-rated physical health after 12-months. Resilience was a complete mediator of the relationship between baseline physical health and recovery of independence when performing activities of daily living, mediating 24.0% of the total effect. Conclusions These findings suggest that enhancing psychological resilience may be an effective strategy for improving recovery outcomes among older post-operative hip fracture patients, alongside traditional physical rehabilitation.