September 09, 2016
Researchers from the University of California suggest that recovery rates following a hip fracture are low for older adults, and even lower for those with cognitive impairment and comorbidities (published online in J Gen Intern Med).
Victoria Tang, MD, and colleagues compared the physical condition and ability of 733 adults older than 65 years before and after a hip fracture. Patient details were retrieved from the Health and Retirement Study (HRS), a nationally representative longitudinal study that measures changes in the health and economic circumstances of Americans as they age.
Participants’ functional recovery was measured based on how they were still independently able to care for themselves post-injury in terms of bathing, dressing, eating, and using the bathroom on their own. Factors such as their ability to walk around a street block or climb stairs without resting were noted, as well as their age and health status prior to the hip fracture.
Of the subjects, 31% returned to their prior daily functioning; 34% and 41% were respectively able to move and climb stairs as before. Things were only marginally better for those who were physically very active before their injury. Of them, 36% could go on living independently without assistance, 32% had no difficulty walking one block, and 29% had no problems climbing stairs.
In a statement concerning the study findings, Dr Tang summarized: “The likelihood of recovery to pre-fracture level of function was less than 50% regardless of one’s previous level of function. The likelihood of returning to a high level of function was particularly low in those who were older than age 85, had multiple comorbid conditions, or had dementia.”
Reportedly, Dr Tang said it is essential to be aware of expected outcomes after a hip fracture, so that patients, families, and supportive caregivers can discuss realistic expectations of recovery. She called for “more frank discussions” about recovery and the “patient’s values and goals of care” so as to optimize the patient’s quality of life. —Amanda Del Signore