Factors Influencing Outcomes of Older Adults After Undergoing Rehabilitation for Hip Fracture (original) (raw)
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Archives of Gerontology and Geriatrics, 2018
The purpose of the present study was focused on the relationship between change in cognition and the functional outcome during rehabilitation in demented and non-demented adult hip fracture patients. We studied seventy consecutive adult patients with hip fracture admitted to our rehabilitation wards. Functional outcome was assessed by the Functional Independence Measure (FIM). The gain in cognition during the rehabilitation process was measured by the difference in Mini Mental State Examination scores at admission and discharge. Data was analyzed by t-test, chi square-test and linear regression. Patients without dementia presented and discharged from the rehabilitation ward with statistically significant higher total, motor, and gain functional independence measure scores compared to patients with dementia. In a multiple regression analyses, gain in Mini Mental State scores examination were not independently associated with higher total and motor functional independence measure scores at discharge (beta = 0.086, p = 0.194; beta = 0.077, p = 0.309, respectively). Our findings suggest that there is no association between functional outcome and cognitive gain at the end of the rehabilitation process among adult hip fracture patients with and without dementia. However hip fracture adult patients with dementia should not be deprived of a post-acute rehabilitation.
Rehabilitation of Older Adults with Hip Fracture: Cognitive Function and Walking Abilities
Journal of the American Geriatrics Society, 2011
OBJECTIVES: To investigate the association between baseline cognitive function and the achievement of walking independence and its maintenance at 1 year in a population of older adults who underwent post‐hip fracture (HF) surgery rehabilitation.DESIGN: Prospective cohort study.SETTING: Department of rehabilitation and aged care.PARTICIPANTS: Three hundred six older adults admitted for post‐HF surgery rehabilitation.MEASUREMENTS: All participants aged 65 and older who were completely unable to walk on admission but able to walk before fracture were stratified according to Mini‐Mental State Examination score (0–15=moderately severe or severe cognitive impairment (CI), 16–23=mild to moderate CI, ≥24=no CI). Walking ability was defined according to the corresponding Barthel Index subitem, with walking independence at discharge being defined as a score of 12 or more out of 15. Walking ability 1 year after discharge was ascertained by telephone interviews with participants or proxies.RESU...
Objective: The aims of this study were to study the mobility recovery in hipfracture patients and determine the influence of cognitive impairment on mobility within the first 3 months after surgery. Design: This prospective cohort study was carried out in an acute publichospital in southern Spain and included 275 patients, 65 years or older, with a hipfracture. Mobility and Cognitive status were measured by Tinetti Performance-Oriented Mobility Assessment and Pfeiffers _ Scale (Short Portable Mental StateQuestionnaire), respectively. Multiple linear regression was used to examine theinfluence of cognitive impairment on mobility. Results: The median Performance-Oriented Mobility Assessment scorechanged from 4 (3 Y 4) points at discharge to 17 (7 Y 22) at 3 months. All degreesof cognitive impairment were negatively associated with gait and balance at 1 and3months aftersurgery( P G 0.01).Age,weightbearing,lengthofhospitalstay,andpostsurgical complications were also identified as independent predictors of mo-bility outcome at 3 months. Conclusions: Cognitive impairment is a negative prognostic factor for therecovery of mobility in elderly patients with a hip fracture. New treatment strategiesare needed for hip fracture patients with cognitive impairment. Key Words: Cognitive Impairment, Elderly, Hip Fracture, Mobility
Influence of Cognitive Impairment on Mobility Recovery of Patients With Hip Fracture
American journal of physical medicine & rehabilitation / Association of Academic Physiatrists, 2016
The aims of this study were to study the mobility recovery in hip fracture patients and determine the influence of cognitive impairment on mobility within the first 3 months after surgery. This prospective cohort study was carried out in an acute public hospital in southern Spain and included 275 patients, 65 years or older, with a hip fracture. Mobility and Cognitive status were measured by Tinetti Performance-Oriented Mobility Assessment and Pfeiffers' Scale (Short Portable Mental State Questionnaire), respectively. Multiple linear regression was used to examine the influence of cognitive impairment on mobility. The median Performance-Oriented Mobility Assessment score changed from 4 (3-4) points at discharge to 17 (7-22) at 3 months. All degrees of cognitive impairment were negatively associated with gait and balance at 1 and 3 months after surgery (P < 0.01). Age, weight bearing, length of hospital stay, and postsurgical complications were also identified as independent p...
Journal of the American Medical Directors Association, 2015
Currently, most rehabilitation services for individuals who sustain a hip fracture are not designed to meet the complex needs of those who also have cognitive impairment. The goal of this review was to identify current best practices for rehabilitation in long-term care settings and approaches to optimize outcomes among individuals with dementia and other cognitive impairments post-hip fracture. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement was used to guide the review. Five electronic databases, including PubMed, EMBASE, CINAHL (EBSCO), Medline (EBSCO), and PsycINFO (EBSCO), were searched for intervention studies published in English language journals. Studies were eligible if they focused on rehabilitation interventions post-hip fracture among older individuals (≥65 years) with cognitive impairment who were living in or transferred to long-term care or postacute/rehabilitation settings post-hip fracture. Studies were excluded if they did not enro...
Archives of Gerontology and Geriatrics, 2009
The purpose of the study was to evaluate patient and system outcomes regarding older community-residing adults who participated in a rehabilitation program following hip fracture surgery. The health care professionals on the rehabilitation unit in this feasibility study had never cared for such patients who were so frail, with multiple co-morbidities including cognitive impairment (CI). After an innovative model of care was developed and the staff trained in the novel approach to care, the unit opened for all clients living within the community who had fractured their hip, regardless of their cognitive impairment. Of the 31 elderly patients consecutively admitted post hip fracture in this retrospective study, 18 were found to have CI postoperatively as determined by a Mini-Mental State Examination score < 23. There were no difference in length of stay, rehabilitation efficiency, and motor FIM gain scores between the two groups of patients. This feasibility retrospective study study suggests that staff can learn how to care for clients with cognitive impairment in rehabilitation settings, and that such clients can achieve outcomes comparable to those without CI in a setting dedicated to caring for patients with a hip fracture.
The impact of cognitive impairment on short-term outcomes of hip fracture patients
Archives of Gerontology and Geriatrics, 2006
The purpose of this study is to examine the differences in outcomes related to recovery after hip fracture among patients with and without cognitive impairment. This is a prospective cohort study of consecutively hospitalized elderly patients with acute hip fracture in a setting utilizing a multidisciplinary hip fracture service. Of the 48 patients admitted with hip fracture, 18 patients were found to have cognitive impairment postoperatively as determined by a Mini-Mental State Examination (MMSE) score 24. Compared to patients without cognitive impairment, cognitively impaired patients reported no difference in the number of activities of daily living (ADL) performed independently or the number of instrumental activities of daily living (IADL) performed independently in the month prior to admission. There was no difference in hospital length of stay. The impaired group had a mean rehabilitation length of stay that was 8 days longer than that of the unimpaired group. Six weeks after surgery, the number of independent activities did not differ between groups. This investigation suggests that although patients with cognitive impairment require longer rehabilitation courses after hip fracture surgery as compared to those who are cognitively unimpaired, they achieve comparable short-term outcomes in the setting of a dedicated hip fracture service. #