Impacto del deterioro cognitivo en la recuperación de la capacidad funcional, la institucionalización y la mortalidad de los ancianos intervenidos de fractura de cadera

Objectives

To determine whether the baseline cognitive state influences functional recovery 6 months after hip fracture.

To discover the relationship of functional results with comorbidity and cognitive impairment (CI)

Methods

This was a prospective cohort study, performed in a hospital in the province of Cáceres, which included 184 patients over 65 years of age who underwent hip fracture between November 2016 and October 2017.

We included clinical, sociodemographic, personal history, and functional dependence variables (Barthel Index, Lawton and Brody Scale) on admission and at 6 months.

Results

Of the total 184 patients, 50% knowingly had CI.

The mean age was 85.48 years (SD: 5.82), 70.9% were women. There were no significant differences in age between the 2 groups (P = .081).

In the pre-post study of each cohort, there were significant differences in all the functional variables studied referring to BADL and IADL at pre-fracture and at 6 months post-fracture (P < .05).

Institutionalization after discharge was 35.3% in the group of patients without CI, compared to 75% of patients with CI.

Conclusions

A significant decrease in BADL and IADL was observed in both groups. The greatest difference occurred in IADL and in patients with CI.

Cognitive impairment prior to fracture seems to be an important predictor of functional and socio-familial outcomes of patients with hip fracture.