Examining Heterogeneity of Functional Recovery Among Older Adults With Hip Fractures

Young, Yuchi; Xiong, Kuangnan; Pruzek, Robert M.; Brant, Larry J.

doi:10.1016/j.jamda.2009.11.007

Cited by 21 publications

(13 citation statements)

References 13 publications

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“…Only self-reported hearing impairment (which may be related to greater communication difficulties and the resulting isolation) and history of heart failure were significantly associated in our study with an unsuccessful outcome in regaining previous levels of autonomy. Other predictors of functional recovery among older hip-fracture patients have been documented in many studies, including cognitive impairment (Givens et al, 2008; Samuelsson et al, 2009), vision impairment, or reported stroke (Young, Xiong, Pruzek, & Brant, 2010); in our study, recovery of previous autonomy for ADLs was statistically significantly associated with a lower score of SPMSQ of Pfeiffer and co-morbidities.…”

Section: Discussion and Applicationsupporting

confidence: 63%

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

et al. 2015

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This article aims to determine the functional recovery of older people, who were previously independent in activities of daily living (ADLs) and without cognitive impairment, in the year following a fall-related hip fracture. A cohort study was carried out among patients admitted to University General Hospital of Albacete (Spain). Consecutive sampling was performed. Variables included demographic, habitual residence, type of hip fracture, mental status (Short Portable Mental Status Questionnaire [SPMSQ] Pfeiffer), and independence in ADLs (according to the Barthel Index [BI]) prior to the fall and after the fracture. For 205 patients, 1 year after surgery, the mean BI score was 78.09 (SD = 25.13); (vs. 90.02 before the hip fracture), 59% showed urinary continence (vs. 79%), and 65% walked without assistance (vs. 82%). Regarding predictors of recovery, results indicate that patients who are older, who suffer complications after hospital discharge, or who reside in nursing homes experience poorer recovery in ADLs. Only 47.9% of the patients regained prior levels of autonomy 1 year after surgery.

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Section: Discussion and Applicationsupporting

confidence: 63%

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

et al. 2015

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“…A number of characteristics of this study are relevant for the interpretation of the results. Heterogeneity of physical fitness in frail institutionalized older adults may affect the association between perceived and performance-based fitness (Montero-Odasso, Bergman, Béland, Sourial, Fletcher, & Dallaire, 2009;Yeung, Woo, Wai-Ting, & Rainer, 2009;Young, Xiong, Pruzek, & Brant, 2010). Second, due to the limited number of very old persons included in this study, the power of the study does not meet the criteria.…”

Section: Discussionmentioning

confidence: 98%

Self-Reported Physical Fitness in Frail Older Persons: Reliability and Validity of the Self-Assessment of Physical Fitness (SAPF)

et al. 2012

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In very old and/or frail older people living in long-term care facilities, physical inactivity negatively affects activities of daily living. The main reason to assess older adults' perceived fitness is to establish the relation with their beliefs about their ability to perform physical activity adjusted to daily tasks. The Self-Assessment of Physical Fitness scale was developed to address these needs. The aim of this study was to estimate the test-retest reliability and construct validity of the scale. 76 elderly people (M age = 86.0 yr., SD = 6.3) completed the test. Cronbach's a was .71. One-week test-retest reliability ICC's ranged from .66 (SAPF aerobic endurance and SAPF balance) to .70 (SAPF sum score). Concurrent validity with the Groningen Fitness Test for the Elderly was fair to moderate. Despite the limited number of participants (N = 76), results suggest that the scale may be useful as an assessment of perceived fitness in older adults.

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“…A previous study reported significant improvement in IADL abilities between 3 months and 1 year after hip fracture [ 14 ]. On the other hand, a 1-year longitudinal study with 225 community residents aged ≥65 showed functional improvement at 2 months following post-acute rehabilitation with continued improvement up to 6 months, after which functional recovery slowed and remained constant through 12 months [ 24 ]. That study population, however, comprised patients with only subcapital hip fractures and the recovery patterns were heterogeneous, indicating that the study results cannot be generalized to all hip fracture patients.…”

Section: Discussionmentioning

confidence: 99%

Does cognitive/physical screening in an outpatient setting predict institutionalization after hip fracture?

Hongisto

Nuotio

Luukkaala

et al. 2016

BMC Musculoskelet Disord

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BackgroundInstitutionalization after hip fracture is a socio-economical burden. We examined the predictive value of Instrumental Activities of Daily Living (IADL) and Mini Mental State Examination (MMSE) for institutionalization after hip fracture to identify patients at risk for institutionalization.MethodsFragility hip fracture patients ≥65 years of age (n = 584) were comprehensively examined at a geriatric outpatient clinic 4 to 6 months after surgery and followed 1 year postoperatively. A telephone interview with a structured inquiry was performed at 1, 4, and 12 months after hip fracture.ResultsAge-adjusted univariate logistic regression analysis revealed that IADL and MMSE scores measured at the outpatient clinic were significantly associated with living arrangements 1 year after hip fracture. Multivariate logistic regression analysis established that institutionalization 1 year after hip fracture was significantly predicted by institutionalization at 4 months (odds ratio [OR] 16.26, 95 % confidence interval [CI] 7.37–35.86), IADL <5 (OR 12.96, 95 % CI 1.62–103.9), and MMSE <20 (OR 4.19, 95 % CI 1.82–9.66). A cut-off value of 5 was established for IADL with 100 % (95 % CI 96 %–100 %) sensitivity and 38 % (95 % CI 33 %–43 %) specificity and for MMSE, a cut-off value of 20 had 83 % (95 % CI 74 %–91 %) sensitivity and 65 % (95 % CI 60 %–70 %) specificity for institutionalization. During the time period from 4 to 12 months, 66 (11 %) patients changed living arrangements, and 36 (55 %) of these patients required more supportive accommodations.ConclusionIADL and MMSE scores obtained 4 to 6 months after hospital discharge may be applicable for predicting institutionalization among fragility hip fracture patients ≥65 years of age at 1 year after hip fracture. An IADL score of ≥5 predicted the ability to remain in the community. Changes in living arrangements also often occur after 4 months.

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Examining Heterogeneity of Functional Recovery Among Older Adults With Hip Fractures

Cited by 21 publications

References 13 publications

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

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

Self-Reported Physical Fitness in Frail Older Persons: Reliability and Validity of the Self-Assessment of Physical Fitness (SAPF)

Does cognitive/physical screening in an outpatient setting predict institutionalization after hip fracture?

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