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Osteoporosis International
Erschienen in:

28.06.2022 | Original Article

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

verfasst von: R. M. Y. Wong, R. W. K. Ng, W. W. Chau, W. H. Liu, S. K. H. Chow, C. Y. Tso, N. Tang, W.-H. Cheung

Erschienen in: Osteoporosis International | Ausgabe 10/2022

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Abstract

Summary

Prevalence of cognitive impairment in hip fractures was 86.5%. MoCA is an independent risk factor of mortality. MoCA score of < 15 is correlated with 11.71 times increased risk of mortality. Early attention and caution should be given to these patients for appropriate intervention to decrease mortality rates.

Introduction

Hip fractures rank amongst the top 10 causes of disability and current mortality of hip fractures is high. Objectives were to determine 1) prevalence of cognitive impairment, 2) whether Montreal Cognitive Assessment (MoCA) score was an independent risk factor associated with mortality, 3) MoCA cut-off that result in high risk of mortality.

Methods

This was a cohort study between July 2019 to June 2020. Inclusion criteria were 1) hip fracture, 2) >  = 65 years old, and 3) low-energy trauma. Patients undergo assessment for cognitive impairment with MoCA. Prevalence was assessed, MoCA cut-off point, and accuracy of statistical model was evaluated. Logistic regression modelling was used to assess association between mortality and MoCA.

Results

There were 260 patients recruited. Two hundred twenty-five patients had MoCA score < 22 signifying cognitive impairment, and 202 patients had MoCA score of < 19. 46 hip fracture patients died at 1-year follow-up. 45 of these patients had MoCA score < 19, and 1 patient had a MoCA > 22. Results showed statistical significance and good model effect (at least 0.8) with MoCA cut-off points between < 15 and < 19 (p < 0.05). After controlling confounding factors, statistical significance still existed in MoCA cut-off point at < 15 (odds ratio (95% CI) = 11.71 (1.14, 120.71); p = 0.04).

Conclusion

Prevalence of cognitive impairment in hip fractures was 86.5%. MoCA is an independent risk factor of mortality in hip fracture patients. MoCA score of < 15 is correlated with 11.71 times increased risk of mortality at 1-year after a hip fracture. AUC with MoCA score < 15 was 0.948. Early attention and caution should be given to these patients for appropriate intervention to decrease mortality rates.
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Metadaten
Titel
Montreal cognitive assessment (MoCA) is highly correlated with 1-year mortality in hip fracture patients
verfasst von
R. M. Y. Wong
R. W. K. Ng
W. W. Chau
W. H. Liu
S. K. H. Chow
C. Y. Tso
N. Tang
W.-H. Cheung
Publikationsdatum
28.06.2022
Verlag
Springer London
Erschienen in
Osteoporosis International / Ausgabe 10/2022
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-022-06426-7

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