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Takeda K, Wada M, Yorozuya K, Hara Y, Watanabe T, Hanaoka H. Factors Associated with Improvement in Activities of Daily Living during Hospitalization: A Retrospective Study of Older Patients with Hip Fractures. Ann Geriatr Med Res 2023; 27:220-227. [PMID: 37635672 PMCID: PMC10556722 DOI: 10.4235/agmr.23.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 07/04/2023] [Accepted: 08/18/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND In this study, we aimed to examine the changes in delirium during hospitalization of patients and its association with behavioral and psychological symptoms of dementia (BPSD), as well as improvements in activities of daily living (ADL). METHODS A longitudinal, retrospective cohort study was conducted involving 83 older adults (≥65 years) with hip fractures. We collected Mini-Mental State Examination (MMSE) and Functional Independence Measure-motor domain (m-FIM) assessment results from the medical charts at two time points: baseline (first week of hospitalization) and pre-discharge (final week before discharge). Additionally, we collected data on delirium and BPSD at three points: baseline, week 2 post-admission, and pre-discharge. We performed univariate logistic regression analysis using changes in m-FIM scores as the dependent variable and MMSE and m-FIM scores at baseline and pre-discharge, along with delirium and BPSD subtypes at baseline, week 2 post-admission, and pre-discharge, as the explanatory variables. Finally, we performed a multivariate logistic regression analysis incorporating the significant variables from the univariate analysis to identify factors associated with ADL improvement during hospitalization. RESULTS We observed significant correlations between ADL improvement during hospitalization and baseline m-FIM and MMSE scores, hypoactive delirium state, and BPSD subtype pre-discharge. Notably, all participants with hypoactive symptoms before discharge exhibited some subtype of delirium and BPSD at baseline. CONCLUSION Besides ADL ability and cognitive function at admission, the presence of hypoactive delirium and BPSD subtype before discharge may hinder ADL improvement during hospitalization.
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Affiliation(s)
- Kazuya Takeda
- Department of Rehabilitation, Kaneda Hospital, Okayama, Japan
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Mineko Wada
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kyosuke Yorozuya
- Faculty of Rehabilitation and Care, Seijoh University, Aichi, Japan
| | - Yuhei Hara
- Department of Occupational Therapy, Chiba Medical Welfare Professional Training College, Chiba, Japan
| | - Toyoaki Watanabe
- Department of Rehabilitation Occupational Therapy, Aichi Medical College, Aichi, Japan
| | - Hideaki Hanaoka
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Kanaya Y, Inoue H, Sawamura H, Hoshino Y, Takeshita K. Rehabilitation after Hip Fracture Surgery Improves Physical and Cognitive Function in Patients with or Without Sarcopenia. Geriatr Orthop Surg Rehabil 2023; 14:21514593231181988. [PMID: 37325702 PMCID: PMC10265336 DOI: 10.1177/21514593231181988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
Introduction Sarcopenia is a prevalent risk factor for falls and fractures, and it affects the physical function and mortality of older people. The present study was performed to assess the prevalence of sarcopenia in patients who underwent rehabilitation after hip fracture surgery and to examine the association of sarcopenia with physical and cognitive function outcomes. Methods This case-control study involved 132 patients who were admitted to a convalescent rehabilitation ward at a single hospital after surgical treatment of hip fractures from April 2018 to March 2020. The skeletal muscle mass index was examined using whole-body dual-energy X-ray absorptiometry. The Asian Working Group for Sarcopenia 2019 diagnostic criteria were applied on admission. We compared the walking speed, Mini-Mental State Examination (MMSE) score, and Functional Independence Measure (FIM) score between the sarcopenia group and non-sarcopenia group on admission and on discharge. Results The prevalence of sarcopenia was 59.8%. In the non-sarcopenia group, the walking speed, MMSE score, FIM total score, FIM motor score, and FIM cognitive score were significantly lower on admission than those on discharge (P < .05). In the sarcopenia group, the walking speed, MMSE score, FIM total score, and FIM motor score were significantly lower on admission than those on discharge (P < .05); there was no significant difference in the FIM cognitive score between admission and discharge. On both admission and discharge, the MMSE score, FIM total score, FIM motor score, and FIM cognitive score were significantly better in the non-sarcopenia group than those in the sarcopenia group. Conclusions After postoperative rehabilitation of hip fractures in patients with and without sarcopenia, physical and cognitive function outcomes on discharge were significantly better than those on admission. Patients with sarcopenia had significantly worse physical and cognitive function outcomes than patients without sarcopenia both on admission and on discharge.
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Affiliation(s)
- Yuji Kanaya
- Department of Orthopaedics, Jichi Medical University, Shimotsuke, Japan
- Department of Orthopaedic Surgery, Tochigi Prefectural Rehabilitation Center, Utsunomiya, Japan
| | - Hirokazu Inoue
- Department of Orthopaedics, Jichi Medical University, Shimotsuke, Japan
| | - Hideaki Sawamura
- Department of Orthopaedics, Jichi Medical University, Shimotsuke, Japan
| | - Yuichi Hoshino
- Department of Orthopaedic Surgery, Tochigi Prefectural Rehabilitation Center, Utsunomiya, Japan
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Nishio K, Arai Y, Abe Y, Takayama M, Fukasawa M, Oikawa D, Ito T, Takatsu M, Iinuma T. Relation between number of teeth, malnutrition, and 3-year mortality in elderly individuals ≥85 years. Oral Dis 2023; 29:827-835. [PMID: 34523194 PMCID: PMC10078753 DOI: 10.1111/odi.14023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 08/21/2021] [Accepted: 09/01/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The number of teeth has been shown to affect mortality. However, it is unclear why the number of teeth is associated with mortality. We focused on the number of teeth and malnutrition and examined whether these differences affect 3-year all-cause mortality among very elderly individuals. METHODS This analysis was conducted using data from the Tokyo Oldest Old Survey on Total Health study. Altogether 513 participants ≥85 years were categorized based on remaining teeth (0, 1-7, 8-18, ≥19). All-cause mortality was determined by calculating the cumulative 3-year survival rate according to the remaining number of teeth and the presence/absence of malnutrition. Further, hazard ratios (HRs) were analyzed using Cox regression analyses. RESULTS No difference was observed according to the number of teeth (p = 0.638), but the presence/absence of malnutrition was significantly associated with mortality (p < 0.001). Malnutrition was independently associated with higher HRs, even after adjusting for confounding factors associated with mortality. (HR: 2.315, 95% CI: 1.431-3.746). Additionally, adjusting for the number of teeth, HR remained significant (HR: 2.365, 95% CI: 1.449-3.853). CONCLUSION In the very elderly, malnutrition-but not the number of teeth-was independently associated with 3-year all-cause mortality after adjusting for various health issues.
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Affiliation(s)
- Kensuke Nishio
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Yasumichi Arai
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Yukiko Abe
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Michiyo Takayama
- Center for Preventive Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Mai Fukasawa
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Daichi Oikawa
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Tomoka Ito
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Masaki Takatsu
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Toshimitsu Iinuma
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
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Indicators of Improvement in Performing Activities of Daily Living Among Older Patients Undergoing Rehabilitation Following Hip Fractures. J Aging Phys Act 2023; 31:75-80. [PMID: 35894998 DOI: 10.1123/japa.2021-0490] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 04/25/2022] [Accepted: 05/04/2022] [Indexed: 02/03/2023]
Abstract
This study aimed to evaluate the relationship between improvement in activities of daily living (ADL) and cognitive status during rehabilitation and assess factors associated with ADL improvement among older patients undergoing rehabilitation after hip fractures. This retrospective cohort study comprised 306 patients aged ≥80 years who underwent hip fracture rehabilitation. The functional independence measure gain during rehabilitation was significantly lower in the group with abnormal cognition than in the group with normal cognition. Mini-Mental State Examination, Charlson Comorbidity Index, daily duration of rehabilitation, and length of hospitalization for rehabilitation were independent factors associated with functional independence measure gain during rehabilitation in the multivariate regression analysis. Although older patients with cognitive impairment had lower ADL improvements during hip fracture rehabilitation, such patients may be able to improve their ADL by undergoing intensive and long rehabilitation programs. They should not refrain from such rehabilitation programs due to older age, fracture, and cognitive impairment.
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5
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What is the subtype of dementia in patients with fragility hip fracture? PLoS One 2022; 17:e0265636. [PMID: 35381010 PMCID: PMC8982891 DOI: 10.1371/journal.pone.0265636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 03/04/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction
Cognitive function is an important factor that affects functional recovery after hip fracture (HipFx) surgery. The literature on the pathophysiology of dementia in HipFx patients is scarce. We performed a differential diagnosis of dementia in HipFx patients using clinical and brain MRI findings.
Methods
This is a prospective study in which brain MRI was evaluated for patients with HipFx for research purposes. One-hundred-and-five HipFx patients (85 females and 20 males) who underwent surgery and were subsequently able to undergo brain MRI at our hospital were evaluated. The mean age was 84 years. The presence of dementia was determined based on clinical findings and whether the patient meets its diagnostic criteria according to the International Classification of Diseases 10th Edition (ICD-10). The differential diagnosis of dementia was made based on brain MRI findings and the dementia diagnostic flow chart published in the Clinical Practice Guideline for Dementia 2017 (Japanese Society of Neurology). The Voxel-based Specific Regional Analysis System for Alzheimer’s Disease (VSRAD) advance 2 diagnostic software was used to evaluate atrophy of the para-hippocampal gyrus.
Results
Fifty-six (53%) patients were clinically diagnosed with dementia according to the ICD-10 criteria. The MRI findings were diverse: Alzheimer’s disease (AD)-type, asymptomatic multiple ischemic cerebral lesions, past symptomatic cerebral infarction or cerebral hemorrhage, Binswanger’s disease (BW)-type, chronic subdural hematoma, disproportionately enlarged subarachnoidal hydrocephalus (DESH), and their combinations thereof. A combination of MRI and clinical findings of dementia patients demonstrated the following distribution of dementia subtypes: AD (n = 20), vascular dementia (n = 33), AD and BW vascular dementia (n = 3).
Conclusion
This study revealed that the brain MRI findings of HipFx patients were diverse. Although vascular dementia is found to be common in this particular population, this could be an incidental finding. Further study is warranted to clarify the specificity of our findings by increasing the number of patients, setting the control, and investigating whether dementia subtypes affect postoperative gait acquisition and fall risk.
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Dutzi I, Schwenk M, Kirchner M, Jooss E, Bauer JM, Hauer K. Influence of Cognitive Impairment on Rehabilitation Received and Its Mediating Effect on Functional Recovery. J Alzheimers Dis 2021; 84:745-756. [PMID: 34569955 DOI: 10.3233/jad-210620] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cognitive impairment (CI) has been reported to negatively impact rehabilitation outcomes. Knowledge about differences in rehabilitation received in dependence of CI as a potential mediating factor is limited. OBJECTIVE To analyze whether CI affects amount and frequency of rehabilitation received and if associations between CI and rehabilitation outcome are mediated by the provided amount of therapy. METHODS Observational cohort study in ward-based geriatric rehabilitation consecutively including 373 patients (mean age 82.0±6.69 years, mean MMSE 23.66±5.31). Outcome measures were amount, frequency, and type of multi-professional therapy sessions and rehabilitation outcome assessed with the Barthel Index (BI). Cognitive status was measured with the Mini-Mental-State Examination (MMSE) classifying three patient subgroups according to cognitive status. RESULTS Patients with more severe CI received least total therapy hours (TTH) (MMSE < 17, 13.67±6.58 versus MMSE 17-26, 16.12±7.19 and MMSE > 26, 17.79±8.88 h, p = 0.014) and were less often included in occupational therapy (MMSE < 17, 48.9%versus MMSE 17-26, 65.5%and MMSE > 26, 71.4%, p = 0.019) and group-based physiotherapy (MMSE < 17, 73.3%versus MMSE 17-26, 88.5%and MMSE > 26, 81.2%, p = 0.027). Regression models showed that CI negatively impacted TTH (β= 0.24, p = 0.003) and rehabilitation outcome (β= 0.41, p = 0.008). In the mediation model, TTH accounted for 23.18%(p < 0.001) of the relationship between CI and rehabilitation outcome. CONCLUSION Cognitive impairment negatively impacted rehabilitation received. The lower TTH partly mediated the negative association between CI and rehabilitation outcome. Future research should identify specific barriers to therapy provision and optimal length, intensity, and dosage of rehabilitation programs to optimize rehabilitation outcomes in CI.
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Affiliation(s)
- Ilona Dutzi
- Department of Geriatric Research, AGAPLESION Bethanien Hospital, Heidelberg, Germany
| | - Michael Schwenk
- Network Aging Research, University of Heidelberg, Heidelberg, Germany.,Department of Clinical Gerontology, Robert-Bosch Hospital, Stuttgart, Germany
| | - Marietta Kirchner
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Eva Jooss
- Department of Geriatric Research, AGAPLESION Bethanien Hospital, Heidelberg, Germany
| | - Jürgen M Bauer
- Department of Geriatric Research, AGAPLESION Bethanien Hospital, Heidelberg, Germany.,Centre for Geriatric Medicine, University of Heidelberg, Heidelberg, Germany
| | - Klaus Hauer
- Department of Geriatric Research, AGAPLESION Bethanien Hospital, Heidelberg, Germany
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Orwig DL, Abraham DS, Hochberg MC, Gruber-Baldini A, Guralnik JM, Cappola AR, Golden J, Hicks GE, Miller RR, Resnick B, Shardell M, Sterling RS, Bajracharya R, Magaziner J. Sex Differences in Recovery Across Multiple Domains Among Older Adults With Hip Fracture. J Gerontol A Biol Sci Med Sci 2021; 77:1463-1471. [PMID: 34555162 PMCID: PMC9255694 DOI: 10.1093/gerona/glab271] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Hip fractures are a public health problem among older adults, but most research on recovery after hip fracture has been limited to females. With growing numbers of hip fractures among males, it is important to determine how recovery outcomes may differ between the sexes. METHODS 168 males and 171 females were enrolled within 15 days of hospitalization with follow-up visits at 2, 6, and 12 months postadmission to assess changes in disability, physical performance, cognition, depressive symptoms, body composition, and strength, and all-cause mortality. Generalized estimating equations examined whether males and females followed identical outcome recovery assessed by the change in each outcome. RESULTS The mean age at fracture was similar for males (80.4) and females (81.4), and males had more comorbidities (2.5 vs 1.6) than females. Males were significantly more likely to die over 12 months (hazard ratio 2.89, 95% confidence interval: 1.56-5.34). Changes in outcomes were significantly different between males and females for disability, gait speed, and depressive symptoms (p < .05). Both sexes improved from baseline to 6 months for these measures, but only males continued to improve between 6 and 12 months. There were baseline differences for most body composition measures and strength; however, there were no significant differences in change by sex. CONCLUSIONS Findings confirm that males have higher mortality but suggest that male survivors have continued functional recovery over the 12 months compared to females. Research is needed to determine the underlying causes of these sex differences for developing future prognostic information and rehabilitative interventions.
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Affiliation(s)
- Denise L Orwig
- Address correspondence to: Denise L. Orwig, PhD, Department of Epidemiology and Public Health, University of Maryland School of Medicine, 660 West Redwood Street, Suite 200, Baltimore, MD 21201, USA. E-mail:
| | - Danielle S Abraham
- Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, USA
| | - Marc C Hochberg
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, USA
| | - Ann Gruber-Baldini
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, USA
| | - Jack M Guralnik
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, USA
| | - Anne R Cappola
- Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, USA
| | - Justine Golden
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, USA
| | - Gregory E Hicks
- Department of Physical Therapy, University of Delaware, Newark, USA
| | - Ram R Miller
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts, USA
| | - Barbara Resnick
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, USA
| | - Michelle Shardell
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, USA
| | - Robert S Sterling
- Department of Orthopedics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rashmita Bajracharya
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, USA
| | - Jay Magaziner
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, USA
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Fukui S, Ohama E, Hattori S. Environmental factors related to sleep latency among inpatients in rehabilitation wards according to functional independence measure cognitive scores. Int J Nurs Pract 2021; 28:e12964. [PMID: 33977600 DOI: 10.1111/ijn.12964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 04/02/2021] [Accepted: 04/26/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND No study has investigated sleep-related environmental factors in patients according to their functional independence measure (FIM) cognitive scores. AIMS The aim of this study is to examine the associations between environmental factors such as noise and sleep latency according to the FIM cognitive scores among inpatients in rehabilitation wards. DESIGN This is a prospective longitudinal study. METHODS This study measured the sleep state using a bed-based actigraphy, environmental data from Environmental Sensor®, and medical record information of 33 inpatients in the rehabilitation wards during 2018. A linear mixed-effect model was used to analyse the associations between sleep latency and environmental factors. Participants were grouped according to high or low FIM cognitive scores. RESULTS The average patient age was 77.2 ± 10.9 years, and 48.5% were male. In the high FIM cognitive score group, the loudness and frequency of noise exceeding 40 dB during sleep latency were significantly associated with sleep latency. In the low FIM cognitive score group, only the noise frequency was associated with sleep latency, and intra-individual variance was larger than that of the high group. CONCLUSION These findings suggest that providing night care with attention to subdued noise is important, particularly for patients with low cognitive functional independence levels measured by the FIM cognitive score.
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Affiliation(s)
- Sakiko Fukui
- Department of Home Care Nursing, Graduate School of Health Care Science, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Geriatric Nursing, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Etsuko Ohama
- Department of Geriatric Nursing, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Satoshi Hattori
- Department of Biomedical Statistics, Graduate School of Medicine, Osaka University, Suita, Japan
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Tarazona-Santabalbina FJ, Ojeda-Thies C, Figueroa Rodríguez J, Cassinello-Ogea C, Caeiro JR. Orthogeriatric Management: Improvements in Outcomes during Hospital Admission Due to Hip Fracture. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3049. [PMID: 33809573 PMCID: PMC7999190 DOI: 10.3390/ijerph18063049] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/05/2021] [Accepted: 03/12/2021] [Indexed: 12/13/2022]
Abstract
Hip fractures are an important socio-economic problem in western countries. Over the past 60 years orthogeriatric care has improved the management of older patients admitted to hospital after suffering hip fractures. Quality of care in orthogeriatric co-management units has increased, reducing adverse events during acute admission, length of stay, both in-hospital and mid-term mortality, as well as healthcare and social costs. Nevertheless, a large number of areas of controversy regarding the clinical management of older adults admitted due to hip fracture remain to be clarified. This narrative review, centered in the last 5 years, combined the search terms "hip fracture", "geriatric assessment", "second hip fracture", "surgery", "perioperative management" and "orthogeriatric care", in order to summarise the state of the art of some questions such as the optimum analgesic protocol, the best approach for treating anemia, the surgical options recommendable for each type of fracture and the efficiency of orthogeriatric co-management and functional recovery.
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Affiliation(s)
- Francisco José Tarazona-Santabalbina
- Department of Geriatric Medicine, Hospital Universitario de la Ribera, Alzira, 46600 Valencia, Spain
- CIBERFES, Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable, Instituto Carlos III, 28029 Madrid, Spain
| | - Cristina Ojeda-Thies
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain;
| | - Jesús Figueroa Rodríguez
- Department of Physical Medicine and Rehabilitation, Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain;
| | | | - José Ramón Caeiro
- Department of Orthopaedics and Traumatology, Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain;
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Shibasaki K, Asahi T, Kuribayashi M, Tajima Y, Marubayashi M, Iwama R, Akishita M, Ogawa S. Potential prescribing omissions of anti-osteoporosis drugs is associated with rehabilitation outcomes after fragility fracture: Retrospective cohort study. Geriatr Gerontol Int 2021; 21:386-391. [PMID: 33641245 DOI: 10.1111/ggi.14145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 01/11/2021] [Accepted: 02/14/2021] [Indexed: 12/18/2022]
Abstract
AIM We investigated the association between rehabilitation outcomes and polypharmacy, potentially inappropriate medications and potential prescribing omissions in older adults with fragility fractures. METHODS In total, we registered 217 older adults with fragility fractures (hip or vertebral) retrospectively and examined the association between rehabilitation outcome and polypharmacy, potentially inappropriate medications and potential prescribing omissions. Polypharmacy was defined as five or more drugs. Potentially inappropriate medications and potential prescribing omissions were defined by the Beers criteria (2015) and the screening tool to alert to treatment criteria version 2, respectively. The outcome was functional independence measure gain (functional independence measure at discharge - functional independence measure at admission). RESULTS Multiple regression analyses revealed no association between functional independence measure gain and polypharmacy (crude: β = 0.058, P = 0.858; adjusted model: β = 0.013, P = 0.869) or potentially inappropriate medications (crude: β = 0.100, P = 0.144; adjusted model: β = 0.084, P = 0.260). However, there was a significant association between functional independence measure gain and potential prescribing omissions (crude: β = 0.167, P = 0.014; adjusted model: β = 0.180, P = 0.016). Participants without potential prescribing omissions (in other words, participants who were prescribed anti-osteoporosis drugs) had a greater functional independence measure gain than participants with potential prescribing omissions (in other words, those that were not prescribed anti-osteoporosis drugs). CONCLUSION To the best of our knowledge, this study is the first to report that participants without potential prescribing omissions had significantly improved rehabilitation outcomes. Geriatr Gerontol Int 2021; 21: 386-391.
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Affiliation(s)
- Koji Shibasaki
- Department of Rehabilitation Medicine, Asahi Neurology and Rehabilitation Hospital, Matsudo City, Japan.,Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Toshiomi Asahi
- Department of Rehabilitation Medicine, Asahi Neurology and Rehabilitation Hospital, Matsudo City, Japan
| | - Mari Kuribayashi
- Department of Rehabilitation Medicine, Asahi Neurology and Rehabilitation Hospital, Matsudo City, Japan
| | - Yuriko Tajima
- Department of Rehabilitation Medicine, Asahi Neurology and Rehabilitation Hospital, Matsudo City, Japan
| | - Miki Marubayashi
- Department of Rehabilitation Medicine, Asahi Neurology and Rehabilitation Hospital, Matsudo City, Japan
| | - Risa Iwama
- Department of Rehabilitation Medicine, Asahi Neurology and Rehabilitation Hospital, Matsudo City, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sumito Ogawa
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Heidari ME, Naghibi Irvani SS, Dalvand P, Khadem M, Eskandari F, Torabi F, Shahsavari H. Prevalence of depression in older people with hip fracture: A systematic review and meta-analysis. Int J Orthop Trauma Nurs 2020; 40:100813. [PMID: 33317987 DOI: 10.1016/j.ijotn.2020.100813] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 05/29/2020] [Accepted: 07/24/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Hip fracture disrupts general health and is one of the most common physical injuries in the elderly. Depression is the most common mood disorder in older people and one of the main complications of hip fractures. AIM AND METHODS We conducted a meta-analysis to estimate the prevalence of depression in older people with hip fractures. Relevant literature published until July 2019 was obtained and screened according to established inclusion criteria. Two researchers independently carried out quality assessment and data extraction before the meta-analysis. We calculated proportions with 95% confidence intervals (CI). To investigate the sources of heterogeneity, we performed subgroup analyses based on study design, follow-up duration, type of fracture, and gender. RESULTS Twenty-seven studies with a combined sample size of 11958 were included. The overall prevalence of depression in older people with hip fracture was 23% (95% CI: 0.18 to 0.29). The lowest and highest prevalence of depression was in Asia (0.19) and America (0.27) respectively. CONCLUSION In this systematic review and meta-analysis the estimated prevalence of depression among older hip fracture patients was 23%. Further research is needed to identify strategies for preventing and treating mood disorders in this population.
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Affiliation(s)
- Mohammad Eghbal Heidari
- Scientific Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, School of Nursing Midwifery, Tehran University of Medical Sciences, Nosrat St, Tohid Sq, Tehran, Iran
| | - Seyed Sina Naghibi Irvani
- Shahid Beheshti University of Medical Sciences, Research Institute for Endocrine Science, Tehran, Iran.
| | - Pegah Dalvand
- Department of Mathematics, Shahrood University of Technology, Shahrood, Iran
| | - Mohaddeseh Khadem
- Scientific Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, School of Nursing Midwifery, Tehran University of Medical Sciences, Nosrat St, Tohid Sq, Tehran, Iran
| | - Fereshte Eskandari
- Scientific Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, School of Nursing Midwifery, Tehran University of Medical Sciences, Nosrat St, Tohid Sq, Tehran, Iran
| | - Fatemeh Torabi
- Scientific Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, School of Nursing Midwifery, Tehran University of Medical Sciences, Nosrat St, Tohid Sq, Tehran, Iran
| | - Hooman Shahsavari
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, School of Nursing Midwifery, Tehran University of Medical Sciences, Nosrat St, Tohid Sq, Tehran, Iran
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Zacharopoulou G, Zacharopoulou V, Voudouri E, Leondiou L, Dermatis Z. Socioeconomic and clinical risk factors of hip fracture among the elderly: a case-control study. ACTA ACUST UNITED AC 2019. [DOI: 10.12968/bjhc.2019.0044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background/Aims The aim of the study was to investigate the socioeconomic and clinical risk factors for hip fracture among a community-dwelling elderly population in Greece. It also aimed to identify characteristics associated with reducing mobility. Methods A case-control study was conducted on 202 patients who had a hip fracture and on 202 other members of the elderly population who did not have a hip fracture as the control group. Results In the multivariate analysis, the variables related to an increased risk of hip fracture were: gender (odds ration [OR]=10.88; 95%confidence Interval [CI]=2.28–51.98), income (OR=32.50; 95%CI=2.96–356.43), income adequacy (OR=129,34; 95%CI=7,09–2360,88), inability to pay expenses/medication (OR=0.02; 95%CI=0.003–0.09), depression (OR=0.03; 95%CI=0.002–0.35), multimorbidity (OR=0.01; 95%CI=0.001–0.97), number of medication (OR=0.02; 95%CI=0.001–0.28) and history of falls (OR=0.08; 95%CI=0.01–0.40). Factors related to deterioration of mobility were: age (OR=28.43; 95%CI:5.45–148.32), dementia (OR=15.60; 95%CI:1.80–135.27), walking ability (OR=0.20; 95%CI:0.07–0.56), balance (OR=9.10; 95%CI:1.89–43.75), use of walking aid (OR=7.42; 95%CI:2.70–20.39), and length of hospitalisation (OR=3.01; 95%CI:1.27–7.14). Conclusions Socioeconomic and clinical factors that lead to an increased risk of hip fracture were identified, as well as factors affecting post-operative functional ability that could guide prevention programmes.
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Affiliation(s)
- Georgia Zacharopoulou
- Faculty of Economy, Management and Informatics, Department of Economics, University of Peloponnese, Tripoli, Greece
| | - Vasiliki Zacharopoulou
- Faculty of Economy, Management and Informatics, Department of Economics, University of Peloponnese, Tripoli, Greece
| | | | | | - Zacharias Dermatis
- Laboratory Teaching Staff, Faculty of Economy, Management and Informatics, Department of Economics, University of Peloponnese, Tripoli, Greece
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