Recovery of Activities of Daily Living Among Older People One Year After Hip Fracture

Córcoles-Jiménez, María Pilar; Villada-Munera, Ascensión; Egido-Fernández, María Ángeles del; Candel-Parra, Eduardo; Moreno-Moreno, Mónica; Jiménez-Sánchez, María Delirio; Piña-Martínez, Antonio

doi:10.1177/1054773815573261

Cited by 22 publications

(28 citation statements)

References 30 publications

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“…The proportions fully recovering post-surgery in our study were consistent with previous research [ 7 , 13 , 14 , 25 ]. According to a review by Dyer et al [ 7 ], about 30% of HF patients did not regain their pre-fracture level of independence in ADL.…”

Section: Discussionsupporting

confidence: 93%

“…Many studies have identified specific demographic or health pre-operative indicators, as well as operative and post-operative predictors of long-term functional outcome among older HF patients who underwent surgical treatment. Age, gender, pre-fracture functioning, health status, including cognitive status, and fracture type are the most common patient-related factors [ 3 , 10 , 11 , 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, although several studies assessed predictors for a change in ADLs and IADLs after HF in elderly patients [ 3 , 10 , 11 , 12 , 13 , 14 ], the possible correlation between limitations in both types of activities with the passage of time have yet to be fully evaluated. Knowledge of how mobility limitations after surgery and prolonged physical disability influence both functionalities at the same follow-up time is needed to gain better understanding of deficits and resources of the older patients.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of a Change and Correlation in Activities of Daily Living after Hip Fracture in Elderly Patients in a Community Hospital in Poland: A Six-Month Prospective Cohort Study

Gańczak

Chrobrowski²,

Korzeń

2018

IJERPH

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Objectives: The consequences of hip fractures (HFs) in elderly persons include a deterioration in functional capacity to perform activities that enable independent living. Since prior research into this issue in Central Europe is rather scant, this study sought to assess the change in activities and instrumental activities of daily living (ADL/IADL) after HF surgery among Polish patients, to study predictors of regaining pre-fracture functional status three and six months later, and to evaluate the correlation between ADL and IADL limitations over time. Methods: A prospective study was conducted between 2011 and 2013 in a tertiary hospital in Western Poland. ADL/IADL were evaluated using the Katz index and Lawton scale, respectively. Results: About half (50.8%) of 120 patients (mean age 80.1 ± SD 7.59) had cognitive impairment (CI). Patients with CI were older (p = 0.002) and had lower scores for pre-fracture ADL/IADL (p = 0.001 and p < 0.001, respectively). Six months after HF, 33.3% of patients failed to return to their pre-fracture ADL and 62.5% failed to return to pre-fracture IADL; 20% of those who could walk before HF were unable to walk after six months. The pre-fracture Spearman correlation coefficient between ADL and IADL summary scores was 0.46; it increased to 0.70 at three months after HF surgery and 0.77 at six months (p < 0.0001). Regaining ADL after six months was more likely in patients with pre-fracture intact intellectual function and independence in pre-fracture ADL; regaining IADL, in younger patients and those with higher pre-fracture IADL scores. Conclusions: Impairment in functional performance is common after HF surgery. ADL and IADL were strongly correlated in these patients, with this increasing over time. Functional outcomes after HF were more dependent on patient characteristics than treatment-related factors. Therefore, more emphasis should be directed towards the pre-fracture period and, in particular, maintaining cognitive function and preserving functional capacity in older persons at high risk of HF.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Predictors of a Change and Correlation in Activities of Daily Living after Hip Fracture in Elderly Patients in a Community Hospital in Poland: A Six-Month Prospective Cohort Study

Gańczak

Chrobrowski²,

Korzeń

2018

IJERPH

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“…The SPMSQ is quick and easy to administer and well suited for screening large populations for cognitive status and severity of deficit [34]. The SPMSQ has been used in several studies [10, 20, 35, 36].…”

Section: Methodsmentioning

confidence: 99%

“…Patients with impaired cognitive status also have a poorer short-term and long-term postoperative outcome after hip fracture than patients with intact cognition [19]. In this case, outcome is defined as a decrease in postoperative recovery relating to activities of daily living (ADL), quality of life and mobility [20], increased length of hospital stay and mortality [21]. The perioperative period is defined as the time periods immediately before, during and following a surgical operation [22].…”

Section: Introductionmentioning

confidence: 99%

Fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures – effects on cognition

et al. 2019

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Background Impaired cognition is a major risk factor for perioperative delirium. It is essential to provide good pain control in patients with hip fractures and especially important in patients with severely impaired cognitive status, as they receive less pain medication, have poorer mobility, poorer quality of life and higher mortality than patients with intact cognition. The purpose of this study was to examine the association between preoperative pain management with nerve blocks and cognitive status in patients with hip fractures during the perioperative period. Methods One hundred and twenty-seven patients with hip fractures participating in a double-blind, randomised, controlled trial were included in this study. At hospital admission, a low-dose fascia iliaca compartment block (FICB) was administered as a supplement to regular analgesia. Cognitive status was registered on arrival at hospital before FICB and on the first postoperative day using the Short Portable Mental Status Questionnaire. Results Changes in cognitive status from arrival at hospital to the first postoperative day showed a positive, albeit not significant, trend in favour of the intervention group. The results also showed that patients with no or a moderate cognitive impairment received 50% more prehospital pain medication than patients with a severe cognitive impairment. FICB was well tolerated in patients with hip fractures. Conclusion Fascia iliaca compartment block given to patients with hip fractures did not affect cognitive status in this study. Patients with a cognitive impairment may receive inadequate pain relief after hip fracture and this discrimination needs to be addressed in further studies. Trial registration EudraCT number 2008–004303-59 date of registration: 2008-10-24.

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Hospital‐associated deconditioning: Not only physical, but also cognitive

Chen

Almirall‐Sanchez

Mockler

et al. 2022

Int J Geriat Psychiatry

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Introduction: Hospital-associated deconditioning (HAD) or post-hospital syndrome is well recognized as reduced functional performance after an acute hospitalization.Recommendations for the management of HAD are still lacking, partly due to a poor understanding of the underlying processes. We aimed to review existing data on risk factors, pathophysiology, measurement tools, and potential interventions. Materials and methods:We conducted a systematic review from bibliographical databases in English, Spanish and French with keywords such as 'post-hospitalization syndrome' or 'deconditioning'. We selected studies that included people aged 60 years or older. Three researchers independently selected articles and assessed their quality. Results: From 4421 articles initially retrieved, we included 94 studies. Most were related to risk factors, trajectories and measures, and focused on the physical aspects of deconditioning. Risk factors for HAD included age, nutritional status, mobility, and pre-admission functional status, but also cognitive impairment and depression. Regarding interventions, almost all studies were devoted to physical rehabilitation and environmental modifications. Only one study focused on cognitive stimulation. Discussion: In the last decade, studies on HAD have mostly focused on the physical domain. However, neurological changes may also play a role in the pathophysiology of HAD. Beyond physical interventions, cognitive rehabilitation and neurological interventions should also be evaluated to improve deconditioning prevention and treatment in the hospital setting.

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Recovery of Activities of Daily Living Among Older People One Year After Hip Fracture

Cited by 22 publications

References 30 publications

Predictors of a Change and Correlation in Activities of Daily Living after Hip Fracture in Elderly Patients in a Community Hospital in Poland: A Six-Month Prospective Cohort Study

Predictors of a Change and Correlation in Activities of Daily Living after Hip Fracture in Elderly Patients in a Community Hospital in Poland: A Six-Month Prospective Cohort Study

Fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures – effects on cognition

Hospital‐associated deconditioning: Not only physical, but also cognitive

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