Background Delirium in elderly patients after hip fracture surgery is believed to be a transient event, although it frequently lasts for more than 4 weeks. Questions/purposes We determined the incidence, risk factors, morbidity, and mortality of prolonged delirium in elderly patients after hip fracture surgery. Patients and Methods We evaluated 232 elderly patients (older than 65 years) (232 hips) who underwent hip fracture surgery for the development and duration of delirium and categorized them into three groups; nondelirium group, transient (B 4 weeks) delirium group, and prolonged ([ 4 weeks) delirium group. Patients underwent a global geriatric evaluation, which included postoperative complications, mortality, and functional and mental status evaluations. The three groups were compared with respect to these variables. Results Seventy patients (30.2%) had delirium develop, and among these, 14 (20%) had prolonged delirium with a total incidence of 6%. Multivariate analysis showed preinjury dementia was a risk factor of prolonged delirium. At the final followup, five (62.5%) of the eight patients who were ambulatory outdoors in the prolonged delirium group became housebound, whereas only 18 (16.4%) of the 110 patients who were ambulatory outdoors in the nondelirium group became housebound. Survival at 40 months was 81.0% (95% confidence interval, 72.6%-89.3%) in the nondelirium group and 63.6% (95% confidence interval, 35.2%-92.

BackgroundConcerns of patients on sexual activity after total hip arthroplasty have not been well studied in Asian patients. This study aimed to determine the following: (1) what are the concerns of patients related to sexual activity after total hip arthroplasty? (2) what are the changes in sexual activity after total hip replacement in Korean patients?MethodsDetails of sexual activity and concerns were obtained using a questionnaire designed specifically for the study. The questionnaire was administered to 64 patients in a face-to-face interview at an outpatient clinic.ResultsPreoperatively, 53.1% of patients experienced difficulties, primarily due to hip pathology and limitations of motion. The median time to the resumption of sexual activity was 3 months postoperatively, and most patients had no increase in the frequency of sexual activity after the total hip replacement. In 39.1% of patients were seen having difficulties with leg positioning following total hip replacement, and they were likely to change coital positions. The most common concern regarding sexual activity of patients was the fear of dislocation. Furthermore, patients with a higher stress level had lower satisfaction rates. Most patients were unable to obtain information on sexual activity following the total hip arthroplasty, and they did not consult with a physician due to the private nature of the topic.ConclusionsDislocation was the most common concern of patients during sexual activity following a total hip arthroplasty, and a higher stress level was found to be associated with a lower satisfaction rate. Because most patients were unprepared to consult a physician, the provision of appropriate information before a consultation might be beneficial.

No abstract

BackgroundSarcopenia causes loss of muscle mass in the elderly and is associated with development of metabolic syndrome in those with obesity. This study evaluated the prevalence of sarcopenic obesity (SO) in healthy Korean elderly women.MethodsThis study was based on data from the Korea National Health and Nutrition Examination Survey IV and V, 2008–2011. Whole body dual energy X-ray absorptiometry and body mass index measurement were performed for all patients. Women aged 65 years or older were included in this study. Total appendicular extremity muscle mass was used to determine the skeletal muscle mass index.ResultsOf 2,396 women aged 65 years or older, a total of 1,491 (62.2%) were underweight, normal weight, or overweight, while 905 (37.8%) were obese. The prevalence of sarcopenia using a cut-off value of 5.4 kg/m2 was 64.9% (63/97) in underweight women, 38.2% (320/838) in normal weight women, 17.1% (95/556) in overweight women, and 6.1% (55/905) in obese women.ConclusionsThe prevalence of sarcopenia was different among groups. The prevalence rate in obese women was lower than that in non-obese women. SO is a new category of obesity in older adults with high adiposity coupled with low muscle mass. The prevalence of SO was lower than that in previous studies because of differences in the definition. A consensus definition of SO needs to be established.

Background Our purpose in this study was to evaluate any deficiency of protein intake for different types of sarcopenia, including osteosarcopenia and sarcopenic obesity and to establish a cut-off value for the relationship between malnutrition, sarcopenia, and osteosarcopenia. Methods The cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey. A total of 4,020 participants (men, 1,698 and women, 2,322) were analyzed in the present study. Sarcopenia is defined according to the criteria for the Asia Working Group for Sarcopenia. To evaluate the adequacy of protein intake, the value obtained by dividing the amount of protein consumed through food by the daily recommended protein amount (50 g/day) of Korean males was defined as the nutrient intake ratio. Results Total protein ( P <0.001 in men, P <0.001 in women) and low dietary intake protein ( P <0.001 in men, P =0.046 in women) were significantly lower in the sarcopenia group than in the normal group, and were significantly lower in the osteosarcopenia group than in the normal group for both men and women. The cut-off value of the adjusted weight of protein intake for sarcopenia was 0.58 g/kg/day in men and 0.98 g/kg/day in women. The cut-off value for adjusted weight of protein intake for osteo-sarcopenia was 0.8 g/kg/day in men and 0.5 g/kg/day in women. Conclusions A comprehensive dietary assessment to detect nutritional deficits that predispose one to or aggravate muscle atrophy is important for establishing a treatment plan for patients with malnutrition.