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Rehabilitation of Older Adults with Hip Fracture: Cognitive Function and Walking Abilities
Author(s) -
Morghen Sara,
Gentile Simona,
Ricci Eleonora,
Guerini Fabio,
Bellelli Giuseppe,
Trabucchi Marco
Publication year - 2011
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2011.03496.x
Subject(s) - medicine , rehabilitation , hip fracture , physical therapy , prospective cohort study , population , activities of daily living , cohort study , functional independence measure , telephone interview , cohort , cognition , physical medicine and rehabilitation , surgery , osteoporosis , psychiatry , social science , environmental health , sociology
OBJECTIVES: To investigate the association between baseline cognitive function and the achievement of walking independence and its maintenance at 1 year in a population of older adults who underwent post‐hip fracture (HF) surgery rehabilitation. DESIGN: Prospective cohort study. SETTING: Department of rehabilitation and aged care. PARTICIPANTS: Three hundred six older adults admitted for post‐HF surgery rehabilitation. MEASUREMENTS: All participants aged 65 and older who were completely unable to walk on admission but able to walk before fracture were stratified according to Mini‐Mental State Examination score (0–15=moderately severe or severe cognitive impairment (CI), 16–23=mild to moderate CI, ≥24=no CI). Walking ability was defined according to the corresponding Barthel Index subitem, with walking independence at discharge being defined as a score of 12 or more out of 15. Walking ability 1 year after discharge was ascertained by telephone interviews with participants or proxies. RESULTS: At discharge, 29.6% of participants with moderately severe or severe CI (n=24), 51.9% with mild to moderate CI (n=56) and 78.6% of participants without CI (n=92) were able to walk independently. Among those who achieved walking independence and were alive at 1 year, 12 participants with moderately severe or severe CI (57.1%), 31 with mild to moderate CI (57.7%) and 73 without CI (78.9%) were still capable of walking independently. CONCLUSION: Although less frequently than in individuals with better cognitive function, walking independence is achievable after HF surgery rehabilitation, and can be maintained at 1 year also in those with moderately severe or severe CI.