Montreal cognitive assessment (MoCA) is highly correlated with 1-year mortality in hip fracture patients

Wong, Ronald Man Yeung; Ng, Raymond Wai Kit; Chau, Wai‐Wang; Liu, W H; Chow, Simon Kwoon‐Ho; Tso, Chi Yin; Cheung, Wing-Hoi

doi:10.1007/s00198-022-06426-7

Cited by 5 publications

(4 citation statements)

References 44 publications

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“…Exclusion criteria were (1) pathological fracture; (2) open fracture; (3) high-energy trauma; (4) other concomitant fracture. Data of all our records are recorded into the Clinical Management System database prospectively [ 15 , 16 ].…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

COVID-19 hip fracture outcomes: The role of Ct values and D-dimer levels?

Tsui,

Chau,

Liu

et al. 2023

Journal of Orthopaedic Translation

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Section: Methodsmentioning

confidence: 99%

“…All hip fracture patients received Ortho-Geriatric co-care at our hospital unit [ 15 ]. We aimed for operative treatment within 48 h for all recruited patients unless anaesthetically unfit as per international standards [ 17 ].…”

Section: Methodsmentioning

confidence: 99%

COVID-19 hip fracture outcomes: The role of Ct values and D-dimer levels?

Tsui,

Chau,

Liu

et al. 2023

Journal of Orthopaedic Translation

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“…vision, syncope, diabetes, cognitive, cerebrovascular and cardiovascular assessment for fall prevention [ [48] , [49] , [50] ]. Cognitive impairment is also highly prevalent in hip fracture patients [ 51 ]. The mainstay of treatment are exercise-based interventions, pain, chronic condition and medication management, visual corrections, education, calcium and vitamin D supplements via a multidisciplinary approach [ 50 ], which prevent falls and addresses other medical conditions.…”

Section: Post-acute Management Of the Osteoporotic Fracturementioning

confidence: 99%

Recommendations on the post-acute management of the osteoporotic fracture - Patients with “very-high” Re-fracture risk

Wong

Cheung

Chow

et al. 2022

Journal of Orthopaedic Translation

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“…Recent prospective studies have emphasized the long known unfavorable prognostic role exerted by cognitive impairment after hip fracture in older people. Impaired cognition has been significantly associated with high mortality rates, 1 , 2 increased risk of recurrent fractures and prosthetic hip dislocations, 3 , 4 blunted ability to function in activities of daily living, 5 , 6 impaired mobility, 7 low likelihood of discharge home and reduced number of days alive and at home, a combined patient-centered outcome measure. 8 , 9 The recent results are in agreement with a lot of previous original studies and various systematic reviews: on the whole, the wider literature has consistently reported poor outcomes in cognitively impaired subjects with a fragility fracture of the hip.…”

mentioning

confidence: 99%

Cognitive assessment to optimize prediction of functional outcome in subacute hip fracture: a short-term prospective study

DI MONACO,

SGARBANTI,

TROMBETTA

et al. 2024

Eur J Phys Rehabil Med

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BACKGROUND Cognitive impairment is a long-known negative prognostic factor after hip fracture. Cognition is usually screened by a single easy-to-administer bedside tool, but recent studies have shown that screening tests may be not enough to rule out cognitive impairment with an unfavorable prognostic role. Unfortunately, data on outcome prediction by further cognitive assessments is sparse. AIM We focused on patients with subacute hip fracture defined cognitively intact or mildly impaired on the screening evaluation performed by the Short Portable Mental Status Questionnaire (SPMSQ). We hypothesized that each of 3 further cognitive tests could independently predict activities of daily living, with optimal prediction of function obtained by performing all three the tests. DESIGN Short-term prospective study. SETTING Rehabilitation ward. POPULATION Inpatients with subacute hip-fracture. METHODS Three cognitive tests were performed on admission to rehabilitation in the patients who made ≤4 errors on the SPMSQ: Montreal Cognitive Assessment (MoCA), Rey Auditory Verbal Learning Test (RAVLT, immediate and delayed recall) and Frontal Assessment Battery (FAB). We assessed activities of daily living by the Barthel index. Successful rehabilitation was defined with a Barthel Index Score ≥85. RESULTS Each of the three cognitive tests assessed before rehabilitation significantly predicted the Barthel index scores measured at the end of the rehabilitation course in our sample of 280 inpatients. However, only the MoCA score retained its significant predictive role when the scores from the three tests were included together as independent variables in a multiple regression model, with adjustments for a panel of potential confounders (P=0.007). The adjusted odds ratio to achieve successful rehabilitation for a seven-point change in MoCA score was 1.98 (CI 95% from 1.02 to 3.83; P=0.042). CONCLUSIONS Contrary to our hypothesis, MoCA but not RAVLT and FAB retained the prognostic role when the scores from the three tests were evaluated together as potential predictors of functional ability in activities of daily living. CLINICAL REHABILITATION IMPACT In the presence of a normal (or mildly altered) score on the SPMSQ in subacute hip fracture, MoCA scores improve prediction of activities of daily living and should be routinely performed.

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Montreal cognitive assessment (MoCA) is highly correlated with 1-year mortality in hip fracture patients

Cited by 5 publications

References 44 publications

COVID-19 hip fracture outcomes: The role of Ct values and D-dimer levels?

COVID-19 hip fracture outcomes: The role of Ct values and D-dimer levels?

Recommendations on the post-acute management of the osteoporotic fracture - Patients with “very-high” Re-fracture risk

Cognitive assessment to optimize prediction of functional outcome in subacute hip fracture: a short-term prospective study

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