|Title||Rates of Recovery to Pre-Fracture Function in Older Persons with Hip Fracture: an Observational Study.|
|Publication Type||Journal Article|
|Year of Publication||2017|
|Authors||Tang, VL, Sudore, RL, Cenzer, I, W Boscardin, J, Smith, AK, Ritchie, CS, Wallhagen, M, Finlayson, E, Petrillo, L, Covinsky, KE|
|Journal||J Gen Intern Med|
|Date Published||2017 Feb|
|Keywords||Activities of Daily Living, Age Factors, Aged, Aged, 80 and over, Comorbidity, Dementia, Female, Geriatric Assessment, Hip Fractures, Humans, Longitudinal Studies, Male, Mobility Limitation, Recovery of Function, Walking|
BACKGROUND: Knowledge about expected recovery after hip fracture is essential to help patients and families set realistic expectations and plan for the future.
OBJECTIVES: To determine rates of functional recovery in older adults who sustained a hip fracture based on one's previous function.
DESIGN: Observational study.
PARTICIPANTS: 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.
MAIN MEASURES: 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.
KEY RESULTS: 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.
CONCLUSIONS: 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.
|User Guide Notes|
|Alternate Journal||J Gen Intern Med|
|PubMed Central ID||PMC5264672|
|Grant List||K24 AG029812 / AG / NIA NIH HHS / United States |
K24 AG054415 / AG / NIA NIH HHS / United States
P30 AG044281 / AG / NIA NIH HHS / United States
T32 AG000212 / AG / NIA NIH HHS / United States