TY - JOUR
T1 - Hip fracture and the influence of dementia on health outcomes and access to hospital-based rehabilitation for older individuals
AU - Mitchell, Rebecca
AU - Harvey, Lara
AU - Brodaty, Henry
AU - Draper, Brian
AU - Close, Jacqueline
PY - 2016/11/5
Y1 - 2016/11/5
N2 - Background: For older individuals who sustain a hip fracture, the presence of dementia can influence their access to hospital-based rehabilitation. Purpose: This study compares the characteristics and health outcomes of individuals with and without dementia following a hip fracture; and access to, and outcomes following, hospital-based rehabilitation in a population-based cohort. Method: An examination of hip fractures involving individuals aged 65 years and older with and without dementia using linked hospitalisation, rehabilitation and mortality records during 2009–2013. Results: There were 8785 individuals with and 23 520 individuals without dementia who sustained a hip fracture. Individuals with dementia had a higher age-adjusted 30-d mortality rate compared to individuals without dementia (11.7% versus 5.7%), a lower proportion of age-adjusted 28-d re-admission (17.3% versus 24.4%) and a longer age-adjusted mean length of stay (22.2 versus 21.9 d). Compared to individuals without dementia, individuals with dementia had 4.3 times (95% CI: 3.90–4.78) lower odds of receiving hospital-based rehabilitation. However, when they did receive rehabilitation they achieved significant motor functional gain at discharge compared to admission using the Functional Independence Measure, but to a lesser extent than individuals without dementia. Conclusion: Within a population-based cohort, older individuals with dementia can benefit from access to, and participation in, rehabilitation activities following a hip fracture. This will ensure that they have the best chance of returning to their pre-fracture physical function and mobility.Implications for Rehabilitation Older individuals with dementia can benefit from rehabilitation activities following a hip fracture. Early mobilisation of individuals post-hip fracture surgery, where possible, is advised. Further work is needed on how best to work with individuals with dementia after a hip fracture in residential aged care to maximise any potential functional gains.
AB - Background: For older individuals who sustain a hip fracture, the presence of dementia can influence their access to hospital-based rehabilitation. Purpose: This study compares the characteristics and health outcomes of individuals with and without dementia following a hip fracture; and access to, and outcomes following, hospital-based rehabilitation in a population-based cohort. Method: An examination of hip fractures involving individuals aged 65 years and older with and without dementia using linked hospitalisation, rehabilitation and mortality records during 2009–2013. Results: There were 8785 individuals with and 23 520 individuals without dementia who sustained a hip fracture. Individuals with dementia had a higher age-adjusted 30-d mortality rate compared to individuals without dementia (11.7% versus 5.7%), a lower proportion of age-adjusted 28-d re-admission (17.3% versus 24.4%) and a longer age-adjusted mean length of stay (22.2 versus 21.9 d). Compared to individuals without dementia, individuals with dementia had 4.3 times (95% CI: 3.90–4.78) lower odds of receiving hospital-based rehabilitation. However, when they did receive rehabilitation they achieved significant motor functional gain at discharge compared to admission using the Functional Independence Measure, but to a lesser extent than individuals without dementia. Conclusion: Within a population-based cohort, older individuals with dementia can benefit from access to, and participation in, rehabilitation activities following a hip fracture. This will ensure that they have the best chance of returning to their pre-fracture physical function and mobility.Implications for Rehabilitation Older individuals with dementia can benefit from rehabilitation activities following a hip fracture. Early mobilisation of individuals post-hip fracture surgery, where possible, is advised. Further work is needed on how best to work with individuals with dementia after a hip fracture in residential aged care to maximise any potential functional gains.
KW - Dementia
KW - hip fracture
KW - hospitalisation
KW - older adults
UR - http://www.scopus.com/inward/record.url?scp=84954223878&partnerID=8YFLogxK
U2 - 10.3109/09638288.2015.1123306
DO - 10.3109/09638288.2015.1123306
M3 - Article
VL - 38
SP - 2286
EP - 2295
JO - Disability and Rehabilitation
JF - Disability and Rehabilitation
SN - 0963-8288
IS - 23
ER -