Hip Fracture as a Predictive Marker for the Risk of Dementia: A Population-Based Cohort Study

Hsu, Warrington W.Q.; Zhang, Xiaowen; Sing, Chor‐Wing; Li, Gloria Hoi-Yee; Tan, K. C. B.; Kung, A. W. C.; Wong, Janus Siu-Him; Wong, Ian C. K.; Cheung, Ching‐Lung

doi:10.1016/j.jamda.2022.07.013

Cited by 7 publications

(10 citation statements)

References 30 publications

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Section: Resultsmentioning

confidence: 99%

“…30 Conversely, another study determined that both malignant melanoma and non-melanoma skin cancers were associated with a decreased ADRD risk, suggesting a protective effect. 60 Kidney disease, 21, 51 hip fracture, 46 and osteoarthritis 54 were also identified as risk factors for ADRD.…”

Section: Resultsmentioning

confidence: 99%

“…Of them, 16 articles focused on cardiovascular and metabolic conditions, 8 addressed infections, inflammatory and immune-related conditions, 7 articles tackled neurological/ophthalmological conditions, 5 examined issues related to physical function and frailty, 4 delved into psychiatric conditions, and the remaining 7 articles investigated other risk factors, such as cancer, 30,60 kidney disease, 21,51 osteoarthritis, 54 and hip fracture. 46 Cardiovascular and metabolic conditions: A clear thread emerging from our analysis is the association of cardiovascular and metabolic conditions with an increased risk for ADRD. Diabetes, for instance, has been spotlighted in several studies.…”

Section: Medical Conditionsmentioning

confidence: 99%

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Assessing Risk Factors for Cognitive Decline Using Electronic Health Records: A Scoping Review

Wang,

Yang,

Sha

et al. 2023

Preprint

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BackgroundElectronic health records (EHR) provide rich, diverse, longitudinal real-world data, offering valuable opportunities to study antecedent risk factors for cognitive decline. However, the extent to which such records have been utilized to understand the risk factors of cognitive decline remains unclear.MethodsWe conducted a systematic review following PRISMA guidelines. We retrieved relevant articles published between January 1, 2010, and April 30, 2023, from PubMed, Web of Science, and CINAHL. Inclusion criteria were studies utilizing EHR to study risk factors for cognitive decline, including subjective cognitive decline, mild cognitive impairment, and dementia. Each article was screened by at least two reviewers. Data elements were manually extracted based on a predefined schema. The studied risk factors were reported.ResultsOf 1,593 articles identified, 80 research articles were selected. Seventy (87.5%) were retrospective cohort studies, 53 (66.3%) used datasets with greater than 10,000 patients, and 69 (86.3%) used EHR datasets from the United States or United Kingdom. Furthermore, 39 (48.8%) targeted medical conditions, 23 (28.8%) related to medical interventions, and 14 (17.5%) related to lifestyle, socioeconomic status, and environmental factors. The majority of studied medical conditions were associated with an elevated risk of cognitive decline, whereas medical interventions addressing these conditions often reduced the risk.ConclusionEHRs have significantly advanced our understanding of medical conditions, interventions, lifestyle, socioeconomic status, and environmental factors related to the risk of cognitive decline.HighlightsElectronic health records are increasingly analyzed to discern dementia risk factors.Eighty articles have been published and most of them were retrospective cohort studies.Most risk factors addressed were related to medical conditions and interventions.A few articles studied lifestyle, socioeconomic status, and environmental factors.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Medical Conditionsmentioning

confidence: 99%

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Assessing Risk Factors for Cognitive Decline Using Electronic Health Records: A Scoping Review

Wang,

Yang,

Sha

et al. 2023

Preprint

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“…The data quality of both databases has been validated for the purpose of epidemiological research 33 , 34 . Both databases have been used to conduct population-wide observational studies associated with hip fracture in Hong Kong 3 , 6 , 35 – 37 and the UK 38 – 40 .…”

Section: Methodsmentioning

confidence: 99%

Unveiling unique clinical phenotypes of hip fracture patients and the temporal association with cardiovascular events

Hsu,

Zhang,

Sing

et al. 2024

Nat Commun

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Cardiovascular events are the leading cause of death among hip fracture patients. This study aims to identify subphenotypes of hip fracture patients and investigate their association with incident cardiovascular events, all-cause mortality, and health service utilisation in Hong Kong and the United Kingdom populations. By the latent class analysis, we show three distinct clusters in the Hong Kong cohort (n = 78,417): Cluster 1 has cerebrovascular and hypertensive diseases, hyperlipidemia, and diabetes; Cluster 2 has congestive heart failure; Cluster 3 consists of relatively healthy patients. Compared to Cluster 3, higher risks of major adverse cardiovascular events are observed in Cluster 1 (hazard ratio 1.97, 95% CI 1.83 to 2.12) and Cluster 2 (hazard ratio 4.06, 95% CI 3.78 to 4.35). Clusters 1 and 2 are also associated with a higher risk of mortality, more unplanned accident and emergency visits and longer hospital stays. Self-controlled case series analysis shows a significantly elevated risk of major adverse cardiovascular events within 60 days post-hip fracture. Similar associations are observed in the United Kingdom cohort (n = 27,948). Pre-existing heart failure is identified as a unique subphenotype associated with poor prognosis after hip fractures.

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“…Patients with dementia are at least twice as likely to sustain a hip fracture 5 . In fact, Hsu et al found hip fractures to be a predictive marker of dementia in elderly patients 6 . Furthermore, a recent analysis by Ioannidis et al showed that patients with dementia have a 67% greater all-cause mortality after hip fracture surgery while specific cerebrovascular mortality is up to 700% greater than non-dementia patients 7 .…”

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confidence: 99%

Dementia and Hip Fractures

Zabawa,

Choubey,

Drake

et al. 2023

JBJS Reviews

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» The elderly population is the fastest growing demographic, and the number of dementia cases in the United States is expected to double to 10 million by 2050.» Patients with dementia are at 3× higher risk of hip fractures and have higher morbidity and mortality after hip fractures.» Hip fracture patients with dementia benefit from early analgesia and timely surgical fixation of fracture.» Early and intensive inpatient rehabilitation is associated with improved postoperative outcomes in patients with dementia.» Coordination of care within a “orthogeriatric” team decreases mortality, and fracture liaison services show potential for improving long-term outcomes in hip fracture patients with dementia.

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Hip Fracture as a Predictive Marker for the Risk of Dementia: A Population-Based Cohort Study

Cited by 7 publications

References 30 publications

Assessing Risk Factors for Cognitive Decline Using Electronic Health Records: A Scoping Review

Assessing Risk Factors for Cognitive Decline Using Electronic Health Records: A Scoping Review

Unveiling unique clinical phenotypes of hip fracture patients and the temporal association with cardiovascular events

Dementia and Hip Fractures

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