| 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 |
| Volume | 32 |
| Issue | 2 |
| Pagination | 153-158 |
| Date Published | 2017 Feb |
| ISSN Number | 1525-1497 |
| 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 |
| Abstract | 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. |
| DOI | 10.1007/s11606-016-3848-2 |
| User Guide Notes | |
| Alternate Journal | J Gen Intern Med |
| Citation Key | 8678 |
| PubMed ID | 27605004 |
| 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 |
