Factors Associated with Recovered Functionality After Hip Fracture in Non-Institutionalized Older Adults: A Case-Control Study Nested in a Cohort

• Published in: Clinical interventions in aging 2021-01, Vol.16, p.1515-1525
• Main Authors: Ramírez-García, Eliseo, García de la Torre, Guadalupe S, Rodríguez Reyes, Erika Judith, Moreno-Tamayo, Karla, Espinel-Bermudez, María Claudia, Sánchez-García, Sergio
• Format: Article
• Language: English
• Subjects: Accidental Falls; Activities of Daily Living; Age; Aged; Aged patients; Arthritis; Cardiovascular disease; Care and treatment; Case-Control Studies; Cerebrovascular disease; Chronic illnesses; Comorbidity; Demographic aspects; Fear; Female; Fractures; functionality; Heart; hip fracture; Hip Fractures - epidemiology; Hip joint; Humans; Loneliness; Male; Mortality; Nutritional status; older adults; Older people; Original Research; Osteoarthritis; Osteoporosis; Pain; Prognosis; Questionnaires; Recovery of Function; Regression analysis; Rehabilitation; Socioeconomic factors; Statistical analysis; Trauma
• ISSN: 1178-1998; 1176-9092; 1178-1998
• DOI: 10.2147/CIA.S320341

To identify factors associated with recovered functionality after a hip fracture in a sample of older adult patients. Nested case-control study in a cohort. Older adults (60 years or older) with a hip fracture were recruited between May 2017 and October 2018. The Barthel scale was used to measure performance in activities of daily living (ADL). A questionnaire was applied to collect information about demographic, clinic, psychological and social variables, and anthropometric measurements were taken. A logistic regression model was built to analyze various factors related to recovered functionality. A total of 346 older adults with a hip fracture were studied (n=173 cases and n=173 controls); 69.4% (n=240) women and 30.6% (n=140) men. Mean age was 79.4 years (±8.7) overall; for cases, 77.4 (±7.9) years and for controls, 81.4 (±9.0). Mean schooling was 6.3 (± 4.3) years. Recovered functionality was associated with normal nutritional status (OR 4.81, 95% CI = 2.54-9.12), absence of heart disease (OR 4.08, 95% CI = 1.48-11.20), self-efficacy for ADL (OR 4.07, 95% CI = 2.15-7.72), absence of depressive symptoms (OR 2.99, 95% CI = 1.69-5.28), prior functionality (OR 2.83, 95% CI = 1.51-5.31), high socioeconomic level (OR 2.41, 95% CI = 1.24-4.65) and transcervical fracture (OR 2.34, 95% CI = 1.05-5.22). In older adults who have suffered a hip fracture, clinical, psychological, and demographic characteristics are associated with recovered functionality. These factors should be considered as a priority in the care of older adults who have experienced hip fractures.