Positive Psychological Factors, Functional Ability, and Participation Among Older Adults Six Months After Hip Fracture

2019 ◽  
Vol 73 (4_Supplement_1) ◽  
pp. 7311505152p1
Author(s):  
Orit Segev-Jacubovski ◽  
Adina Maeir ◽  
Hagit Magen
Keyword(s):  
Older Adults ◽  
Hip Fracture ◽  
Functional Ability ◽  
Psychological Factors

scholarly journals PSYCHOLOGICAL FACTORS ASSOCIATED WITH AMBULATION PERFORMANCE AFTER HIP FRACTURE AMONG HOME-DWELLING OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S419-S419
Author(s):  
Richard H Fortinsky
Keyword(s):  
Older Adults ◽  
Hip Fracture ◽  
Gait Speed ◽  
Psychological Factors ◽  
Walk Distance ◽  
Balance Confidence ◽  
Minute Walk Distance ◽  
Minute Walk ◽  
Walking Endurance

Abstract Many older adults fail to resume optimal community living after hip fracture due to sustained limitations in ambulation capacity, yet reasons remain poorly understood. Roles of psychological factors in affecting ambulation performance post-hip fracture remain particularly understudied; depression has been associated with poorer self-reported functional status, and little is known about self-perceived balance confidence, resilience, and optimism. This presentation reports associations between each psychological factor, measured at CAP baseline, and gait speed and walking endurance, measured at baseline and 16 weeks later. In the CAP cohort (N=210), baseline mean/sd 4-meter gait speed (gs), 50-foot walk gs, and 6-minute walk distance were: 0.60/0.19 meters per second (mps); 0.67/0.20 mps; and 186.9/55.4 meters, respectively. In multivariate models, balance confidence was positively associated with all baseline ambulation measures (p<0.001 in all models), and resilience was positively associated with all 16-week follow-up ambulation measures (p>0.05 in all models). Implications of results will be discussed.

scholarly journals A health care record review of early mobility activities after fragility hip fracture: Utilizing the French systematic method to inform future interventions

2020 ◽  
Author(s):  
Lynn Haslam-Larmer ◽  
Kevin Woo ◽  
Mohammad Auais ◽  
Catherine Donnelly ◽  
Vincent DePaul
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Cognitive Impairment ◽  
Hip Fracture ◽  
Functional Ability ◽  
Care Providers ◽  
Systematic Method ◽  
Early Mobility ◽  
Fragility Hip Fracture ◽  
Practice Gap

Abstract BackgroundA fragility hip fracture is a serious injury in older adults. After experiencing a fracture, a large percentage of patients do not regain their pre-fracture level of mobility. There are several international guidelines recommending early mobility after surgery. We do not know the usage of these early mobility recommendations by health care providers within our institution. An evidence-to-practice gap occurs when there is a failure to implement best practices. Utilization of a systematic method allows for a strategic approach to assessment of an evidence-to-practice gap. There were two aims of this project; to describe early mobility activities undertaken on one post surgical unit and b) to identify if there is an evidence-to-practice gap.MethodsAt a large tertiary centre in Toronto, Ontario, medical records from one calendar year were abstracted for older adults (≥65 years of age) recovering from fragility hip fracture repair. Data regarding demographics, co-morbidities, surgery type, post-operative mobility activities, and any post-operative complications were collected. Primary outcomes were evidence of early mobility activities and a comparison to Health Quality Ontario recommendations for fragility hip fracture care.ResultsBetween 11% - 50% of patients are not participating in early mobility activities. By postoperative day five only two patients had walked over 50 metres. Those with low pre-fracture functional ability and a cognitive impairment consistently experienced lower rates of participation compared to patients with a high pre-fracture functional ability and no cognitive impairment. Chi-square tests and regression analysis did not reveal any significant associations with variables.ConclusionsThere is very limited participation in early mobility activities after surgery. The study was unable to identify any significant relationships between several variables that may impact participation. This chart review identified the processes that have been sustained and highlights potential areas for future interventions.

scholarly journals Characteristics and Outcomes of Hip Fracture Patients Hospitalized in an Orthogeriatric Unit Versus an Orthopedic Department: A Retrospective Cohort Study

2021 ◽  
Vol 12 ◽  
pp. 215145932098629 ◽  
Author(s):  
Yulia Bugaevsky ◽  
Yochai Levy ◽  
Avital Hershkovitz ◽  
Irena Ocheretny ◽  
Adaya Nissenholtz ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Hip Fracture ◽  
Hip Fractures ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Functional Independence ◽  
Functional Improvement ◽  
Orthopedic Department ◽  
Successful Recovery

Introduction: Hip fractures are a significant health risk in older adults and a major cause of morbidity, functional decline and mortality. Our aim was to compare clinical outcomes of older patients hospitalized in an ortho-geriatric (OG) unit to those hospitalized in an orthopedic department (OD) for surgical treatment of a hip fracture. Methods: A retrospective cohort study of hip fractured patients hospitalized between 2015-2016 in a single tertiary university-affiliated medical center. Included were patients aged 65 and older who had undergone hip fracture surgery and were admitted to either a geriatric or orthopedic ward. Results: 441 patients met the inclusion criteria (195 in the OG unit, 246 in the OD); 257 were transferred to an affiliated geriatric center hospital (107 from the OG unit and 127 from the OD) for rehabilitation. Patients in the OG unit were older, more cognitively and functionally impaired and with more comorbidities. The 1-year mortality rate was significantly lower in the OD group (OR 0.32, CI 95% 0.19-0.53, p < 0.001), however, after propensity matching, the 30-day and 1 year mortality rates were similar in both groups. No difference was found in the rehabilitation length of stay between the groups. The functional independence measure improvement was similar in both groups, with a non-significant trend toward better functional improvement among OG unit patients. Conclusions: Despite the higher complexity of patients, worse baseline functional capacity in the OG unit, improvement after rehabilitation was similar in both groups. These results demonstrate the advantages of the OG unit in treating and stabilizing frail older adults, thus maximizing their chances for a successful recovery after hip fractures. Level of Evidence: Level IV

The Association Between Sarcopenia and Postoperative Outcomes Among Older Adults With Hip Fracture: A Systematic Review

2021 ◽  
pp. 073346482110065
Author(s):  
Ming-Hsiu Chiang ◽  
Yi-Jie Kuo ◽  
Yu-Pin Chen
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Hip Fracture ◽  
Postoperative Mortality ◽  
Clinical Event ◽  
High Morbidity ◽  
Adverse Health Outcomes ◽  
Age Related ◽  
Study Selection ◽  
And Function

Hip fracture is a serious clinical event with high morbidity and mortality. Sarcopenia is characterized by age-related loss of muscle mass and function, leading to several adverse health outcomes. In this systematic review, no limitation criteria were used for study selection and 327 studies were identified in the initial search. Of these, 11 studies comprising a total of 2,314 patients were selected. The overall proportion of older adults with hip fracture having sarcopenia was 44%, with a disparity of approximately 10% between men and women. Most studies have indicated that older adults with sarcopenia had poorer postoperative functional recovery than those without sarcopenia; the association between sarcopenia and high postoperative mortality or long hospital stay was heterogeneous. Well-organized studies with longer follow-up periods are warranted.

scholarly journals Prevalence and risk factors of delirium and subsyndromal delirium in older adults

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Maha Hosam El-Din Ibrahim ◽  
Manal Elmasry ◽  
Fady Nagy ◽  
Ahmed Abdelghani
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Functional Ability ◽  
Cognitive Assessment ◽  
Length Of Hospital Stay ◽  
Assessment Method ◽  
Assessment Tools ◽  
Subsyndromal Delirium ◽  
Confusion Assessment ◽  
Definition Of

Abstract Background Delirium is a common geriatric problem associated with poor outcomes. Subsyndromal delirium (SSD) is characterized by the presence of certain symptoms of delirium yet, not satisfying the definition of full-blown delirium, defined by categorical elements, and is usually referred to as the presence of one or more symptoms in the confusion assessment method (CAM). This study aimed to investigate the prevalence and risk factors of delirium and SSD in older adults admitted to the hospital. Five hundred eighty-eight elderly (above 65 years) Egyptian patients were recruited from January 2019 to February 2020. After explaining the purpose of the study and assuring the confidentiality of all participants, an informed consent was obtained from the participant or a responsible care giver for those who were not able to give consent. All patients were subjected ‘on admission’ to thorough history taking, clinical examination, and comprehensive geriatric assessment including confusion assessment tools, mini-mental state examination, and functional assessment using Barthel index score. Results The current study showed that 19.6% of patients had delirium and 14.1% of patients had SSD with combined prevalence of 33.7%. Most common causes included metabolic, infection, organic brain syndrome, and dehydration. The current study reported significant proportionate relation between cognitive assessment and functional ability, so patients with a score of 23 MMSE had good functional ability, while cognitive assessment using mini-mental score shows inversed relation to delirium and SSD using CAM score. Conclusion Delirium is independently associated with adverse short-term and long-term outcomes, including an increase in mortality, length of hospital stay, discharge to an institution, and functional decline on discharge. Subsyndromal delirium (SSD) is characterized by the presence of certain symptoms of delirium, not yet satisfying the definition of full-blown delirium but it can identify patients with early cognitive and functional disabilities, and because of high prevalence of delirium and SSD. Efforts to prevent or early detection may identify patients who warrant clinical attention.

Fall-related cognition, motor function, functional ability, and depression measures in older adults with dementia

2020 ◽  
Vol 47 (4) ◽  
pp. 487-494
Author(s):  
Hyun-Ju Park ◽  
Nam-Gi Lee ◽  
Tae-Woo Kang
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Motor Function ◽  
Functional Ability ◽  
Fall Risk ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Korean Version ◽  
Risk Of Fall ◽  
Clinical Measurements

BACKGROUND: As the severity of dementia progresses over time, cognition and motor functions such as muscle strength, balance, and gait are disturbed, and they eventually increase the risk of fall in patients with dementia. OBJECTIVE: To determine the relationship between the fall risk and cognition, motor function, functional ability, and depression in older adults with dementia. METHODS: Seventy-four older adults diagnosed with dementia were recruited. Clinical measurements included the Fall Risk Scale by Huh (FSH), Korean version of the Mini-Mental State Examination (MMSE-K), hand grip strength (HGS), Tinetti Performance Oriented Mobility Assessment (POMA), 10-m walk test (10-MWT), Korean version of the Modified Barthel Index (MBI-K), and the Geriatric Depression Scale (GDS). RESUTLS: The MMSE-K was significantly correlated with the FSH, HGS, and the MBI-K, and FSH was significantly correlated with all of the other outcome measures. In particular, the MMSE-K, HGS, POMA, and the MBI-K were negatively correlated with fall history among the FHS sub-items. Additionally, the MMSE sub-item, attention/concentration was associated with the FSH, HGS, POMA, and the MBI-K. CONCLUSIONS: These findings suggest that falling is significantly related to impaired cognition, reduced muscle strength, impaired balance, gait, and activities of daily living abilities, and depression in older adults with dementia.

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