Rates of Recovery to Pre-Fracture Function in Older Persons with Hip Fracture: an Observational Study
Male
Aging
Physical Injury - Accidents and Adverse Effects
Clinical Sciences
Comorbidity
Walking
03 medical and health sciences
0302 clinical medicine
General & Internal Medicine
Activities of Daily Living
80 and over
Humans
Longitudinal Studies
Mobility Limitation
Geriatric Assessment
Aged
Aged, 80 and over
2. Zero hunger
function
geriatrics
palliative care
Hip Fractures
Rehabilitation
Age Factors
Recovery of Function
hip fracture
Dementia
Female
activities of daily living
DOI:
10.1007/s11606-016-3848-2
Publication Date:
2016-09-07T14:51:30Z
AUTHORS (10)
ABSTRACT
Knowledge about expected recovery after hip fracture is essential to help patients and families set realistic expectations and plan for the future.To determine rates of functional recovery in older adults who sustained a hip fracture based on one's previous function.Observational study.We identified subjects who sustained a hip fracture while enrolled in the nationally representative Health and Retirement Study (HRS) using linked Medicare claims. HRS interviews subjects every 2 years. Using information from interviews collected during the interview preceding the fracture and the first interview 6 or more months after the fracture, we determined the proportion of subjects who returned to pre-fracture function.Functional outcomes of interest were: (1) ADL dependency, (2) mobility, and (3) stair-climbing ability. We examined baseline characteristics associated with a return to: (1) ADL independence, (2) walking one block, and (3) climbing a flight of stairs.A total of 733 HRS subjects ≥65 years of age sustained a hip fracture (mean age 84 ± 7 years, 77 % female). Thirty-one percent returned to pre-fracture ADL function, 34 % to pre-fracture mobility function, and 41 % to pre-fracture climbing function. Among those who were ADL independent prior to fracture, 36 % returned to independence, 27 % survived but needed ADL assistance, and 37 % died. Return to ADL independence was less likely for those ≥85 years old (26 % vs. 44 %), with dementia (8 % vs. 39 %), and with a Charlson comorbidity score >2 (23 % vs. 44 %). Results were similar for those able to walk a block and for those able to climb a flight of stairs prior to fracture.Recovery rates are low, even among those with higher levels of pre-fracture functional status, and are worse for patients who are older, cognitively impaired, and who have multiple comorbidities.
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