Aim To compare functional, cognitive, and nutritional status before and after COVID-19 pandemic among institutionalized older adults. Findings High frequencies of functional, cognitive, emotional, and nutritional decline were found after the first wave of COVID19 pandemic independently of the infection. Message Health workers and managers should take measures to prevent this decline in institutionalized elderly and its potential adverse effects.

Protein malnutrition and vitamin D deficiency are the rule in acute HF patients. Energy malnutrition and sarcopenia are also common. A nutritional assessment in these patients should include these aspects together.

Purpose: The aim of this study was to develop a new comprehensive preoperative risk score for predicting mortality during the first year after hip fracture (HF) and its comparison with 3 other risk prediction models. Methods: All patients admitted consecutively with a fragility HF during 1 year in a co-managed orthogeriatric unit at a university hospital were assessed and followed for 1 year. Factors independently associated with 1-year mortality were used to create the HULP-HF (Hospital Universitario La Paz – Hip Fracture) score. The predictive validity, discrimination and calibration of the HULP-HF score, the American Society of Anesthesiologists (ASA) scale, the abbreviated Charlson comorbidity index (a-CCI) and the Nottingham Hip Fracture score (NHFS) were compared. Discriminative performance was assessed using the area under the curve (AUC) and calibration by the Hosmer-Lemeshow goodness-of-fit-test. Results: 509 patients were included. 1-year mortality was 23.2%. The 8 independent mortality risk factors included in the HULP-HF score were age >85 years, baseline functional and cognitive impairment, low body mass index, heart disease, low hand-grip strength, anaemia on admission, and secondary hyperparathyroidism associated with vitamin D deficiency. The AUC was 0.79 in the HULP-HF score, 0.66 in the NHFS, 0.61 in the abbreviated CCI and 0.59 in the ASA scale. The HULP-HF score, the NHFS and the abbreviated CCI all presented good levels of calibration ( p > 0.05). Conclusions: The HULP-HF score has a predictive capacity for 1-year mortality in HF patients slightly superior to that of other previously existing scores.