Influence of Cognitive Impairment on Mobility Recovery of Patients With Hip Fracture

Am J Phys Med Rehabil. 2017 Feb;96(2):109-115. doi: 10.1097/PHM.0000000000000550.

Abstract

Objective: The aims of this study were to study the mobility recovery in hip fracture patients and determine the influence of cognitive impairment on mobility within the first 3 months after surgery.

Design: This prospective cohort study was carried out in an acute public hospital in southern Spain and included 275 patients, 65 years or older, with a hip fracture. Mobility and Cognitive status were measured by Tinetti Performance-Oriented Mobility Assessment and Pfeiffers' Scale (Short Portable Mental State Questionnaire), respectively. Multiple linear regression was used to examine the influence of cognitive impairment on mobility.

Results: The median Performance-Oriented Mobility Assessment score changed from 4 (3-4) points at discharge to 17 (7-22) at 3 months. All degrees of cognitive impairment were negatively associated with gait and balance at 1 and 3 months after surgery (P < 0.01). Age, weight bearing, length of hospital stay, and postsurgical complications were also identified as independent predictors of mobility outcome at 3 months.

Conclusions: Cognitive impairment is a negative prognostic factor for the recovery of mobility in elderly patients with a hip fracture. New treatment strategies are needed for hip fracture patients with cognitive impairment.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognitive Dysfunction / complications
  • Cognitive Dysfunction / physiopathology*
  • Female
  • Gait / physiology*
  • Hip Fractures / physiopathology*
  • Hip Fractures / psychology*
  • Humans
  • Male
  • Postural Balance
  • Prospective Studies
  • Recovery of Function*
  • Time Factors
  • Weight-Bearing