Increase in Disability Prevalence Before Hip Fracture.

TitleIncrease in Disability Prevalence Before Hip Fracture.
Publication TypeJournal Article
Year of Publication2015
AuthorsCenzer, I, W Boscardin, J, Ritchie, CS, Wallhagen, M, Covinsky, KE
JournalJ Am Geriatr Soc
Date Published2015 Oct
ISSN Number1532-5415
KeywordsActivities of Daily Living, Age Factors, Aged, Aged, 80 and over, Dementia, Disability Evaluation, Disabled Persons, Educational Status, Female, Health Surveys, Hip Fractures, Humans, Income, Male, Mobility Limitation, Prevalence, United States

OBJECTIVES: To establish the prevalence and correlates of disability during the 2 years before hip fracture.

DESIGN: Data from participants who experienced hip fracture in the Health and Retirement Study (HRS) with hip fracture identified using linked Medicare claims. Each participant was interviewed at varying time points in the 2 years before hip fracture. Disability was defined as self-report of the need for assistance in any activity of daily living (walking across the room, eating, bathing, dressing, using the toilet, transferring). Based on the timing between interview and hip fracture, prevalence of disability was calculated in the cohort as a whole over the 2 years before hip fracture and in subgroups defined according to demographic and clinical characteristics.

SETTING: The HRS is a nationally representative longitudinal study (1992-2010).

PARTICIPANTS: HRS participants aged ≥65 with hip fracture (mean age at fracture 84, 77% female).

RESULTS: The adjusted prevalence of disability was 20% (95% confidence interval (CI) = 14-25%) 2 years before hip fracture, with little change until approximately 10 months before fracture, when it started to rise, reaching 44% (95% CI = 33-55%) in the month before hip fracture. The prevalence of disability was highest in the last month before fracture for persons aged 85 and older (53%) and for those with dementia (60%).

CONCLUSION: Care models for hip fracture need to consider not only the acute medical and surgical needs, but also the high level of need for supportive care and caregiver assistance that chronically disabled individuals require.


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Endnote Keywords

medicare/ADMINISTRATIVE DATA/Disabilities/Hip Fractures/ADL/IADL

Endnote ID


Alternate JournalJ Am Geriatr Soc
Citation Key8229
PubMed ID26480970
PubMed Central IDPMC4699653
Grant List1K23AG040772 / AG / NIA NIH HHS / United States
R01 NR013347 / NR / NINR NIH HHS / United States
K23 AG040772 / AG / NIA NIH HHS / United States
K24 AG029812 / AG / NIA NIH HHS / United States
P30 AG044281 / AG / NIA NIH HHS / United States