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Effect of cognitive impairment on basic activities of daily living in hip fracture patients: a 1-year follow-up

  • Section on Longitudinal Studies
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Abstract

Background and aims: To compare changes in basic self-care activities in various cognitive groups of hip fracture patients by the Katz Index of Independence in activities of daily living (ADL). Methods: 117 community-dwelling elderly subjects with acute hip fracture (age 67–92 years), referred to the geriatric unit of Jyväskylä Central Hospital for rehabilitation, participated in the study. Basic self-care activities were evaluated by the Katz ADL Index and cognition by the Mini-Mental State Examination (MMSE). Results: Prior to hip fracture, the patients in the lowest MMSE group had a significantly lower Katz Index than the other three groups (p<0.001). Disability increased in a statistically significantly way post-surgery in all four MMSE groups (p<0.001). In the two lower MMSE groups, the Katz Index remained at the lower level, and in the two higher groups it improved in a statistically significant way from 2 weeks to 3 months post-operatively, after which it deteriorated slightly. A significantly larger proportion of patients in the higher MMSE groups were independent in all basic ADLs, both before and after fracture (from p=0.023 to p<0.001), except in continence prior to fracture. Conclusions: Prior to hip fracture, patients with low MMSE scores had a significantly greater degree of basic ADL dependence than the other three groups. Despite similar post-operative multidisciplinary treatment, functional ability remained at the lower level in the two lower MMSE groups, whereas recovery was much better in the higher MMSE groups.

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Jyväskylä Central Hospital and Department of Health Sciences, University of Jyväskylä, Finland

    Arja Häkkinen PhD

  2. Department of Physical Medicine and Rehabilitation, Jyväskylä Central Hospital, Jyväskylä

    Maarit Heinonen

  3. Rheumatism Foundation Hospital, Heinola

    Hannu Kautiainen & Raimo Sulkava

  4. Social Insurance Institution, Helsinki

    Tiina Huusko

  5. Section of Geriatrics, Department of Public Health and General Practice, University of Kuopio, Kuopio

    Raimo Sulkava

  6. Department of Geriatrics, Jyväskylä Central Hospital, Jyväskylä, Finland

    Pertti Karppi

Authors
  1. Arja Häkkinen PhD
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  2. Maarit Heinonen
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  3. Hannu Kautiainen
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  4. Tiina Huusko
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  5. Raimo Sulkava
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  6. Pertti Karppi
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Correspondence to Arja Häkkinen PhD.

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Häkkinen, A., Heinonen, M., Kautiainen, H. et al. Effect of cognitive impairment on basic activities of daily living in hip fracture patients: a 1-year follow-up. Aging Clin Exp Res 19, 139–144 (2007). https://doi.org/10.1007/BF03324680

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  • DOI: https://doi.org/10.1007/BF03324680

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