An 11-year review of hip fracture hospitalisations, health outcomes, and predictors of access to in-hospital rehabilitation for adults ≥ 65 years living with and without dementia: a population-based cohort study

• Published in: Osteoporosis international 2020-03, Vol.31 (3), p.465-474
• Main Authors: Mitchell, R., Draper, B., Brodaty, H., Close, J., Ting, H.P., Lystad, R., Harris, I., Harvey, L., Sherrington, C., Cameron, I.D., Braithwaite, J.
• Format: Article
• Language: English
• Subjects: Aftercare; Aged; Australia; Cohort analysis; Cohort Studies; Dementia; Dementia - epidemiology; Dementia disorders; Elder care; Endocrinology; Female; Fractures; Health risk assessment; Hip; Hip Fractures - epidemiology; Hospitalization; Hospitals; Humans; Male; Medicine; Medicine & Public Health; Older people; Original Article; Orthopedics; Outcome Assessment, Health Care; Patient Discharge; Population studies; Population-based studies; Rehabilitation; Retrospective Studies; Rheumatology; Trends
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-019-05260-8

Summary This study examined hip fracture hospitalisation trends and predictors of access to rehabilitation for adults aged ≥ 65 years living with and without dementia. The hospitalisation rate was 2.5 times higher for adults living with dementia and adults who lived in aged care were between 4.8 and 9.3 times less likely to receive rehabilitation. Introduction To examine hip fracture hospitalisation temporal trends, health outcomes, and predictors of access to in-hospital rehabilitation for older adults living with and without dementia. Methods A population-based retrospective cohort study of adults aged ≥ 65 years hospitalised with a hip fracture during 2007–2017 in New South Wales, Australia. Results Of the 69,370 hip fracture hospitalisations, 27.1% were adults living with dementia. The hip fracture hospitalisation rate was 2.5 times higher for adults living with dementia compared with adults with no dementia (1186.6 vs 492.9 per 100,000 population). The rate declined by 6.1% per year (95%CI − 6.6 to − 5.5) for adults living with dementia and increased by 1.0% per year (95%CI 0.5–1.5) for adults with no dementia. Multivariable associations identified that adults living with dementia who experienced high frailty and increasing age were between 1.6 and 1.8 times less likely to receive in-hospital rehabilitation. Adults who were living in long-term aged care facilities were between 4.8 and 9.3 times less likely to receive in-hospital rehabilitation which varied by the presence of dementia or delirium. Conclusion Consistent criteria should be applied to determine rehabilitation access, and rehabilitation services designed for older adults living with dementia or in aged care are needed. Highlights • Adults living with dementia were able to make functional gains following hip fracture rehabilitation. • Need to determine consistent criteria to determine access to hip fracture rehabilitation. • Rehabilitation services specifically designed for adults living with dementia or in aged care are needed.