Cognitive Impairment and 1-Year Outcome in Elderly Patients with Hip Fracture

BACKGROUND Hip fracture is common in elderly patients. However, few effective studies had linked cognitive impairment to patient clinical outcome. MATERIAL AND METHODS A total of 244 elderly hip fracture patients were prospectively followed up for 12 months. At 30 days, 6 months, and 1 year after hip repair surgery, patients and/or primary caregivers were interviewed by phone by trained, blinded interviewers. Functional evaluation, from pre-injury through 1 year after the operation, was assessed using the Barthel Index. RESULTS Among 244 patients, 43 were diagnosed as having cognitive impairment (Mini-Mental State Examination score <24). Compared to those without cognitive impairment, the 30-day, 6-month, and 1-year mortalities in the impaired patients were significantly higher than that of the cognitively intact patients. Six months after hip repair surgery, the cognitively intact patients presented significantly higher activities of daily living (ADL) scores than the cognitively impaired patients, and only 38.5% of impaired patients returned to their pre-operation baseline levels afterwards. The ADL scores in the impaired patients were similar to the intact ones at 1 year after the operation. CONCLUSIONS Although they had a higher risk of mortality in hip fracture, functional gain in the cognitively impaired patients was similar to that in the cognitively intact patients at 1-year follow-up.