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Rehabilitation of Older Adults with Hip Fracture: Cognitive Function and Walking Abilities

Authors

  • Sara Morghen PsyD,

    1. From the Geriatric Research Group, Brescia, Italy
    2. Department of Rehabilitation and Aged Care, “Ancelle della Carità” Hospital, Cremona, Italy
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  • Simona Gentile MD,

    1. From the Geriatric Research Group, Brescia, Italy
    2. Department of Rehabilitation and Aged Care, “Ancelle della Carità” Hospital, Cremona, Italy
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  • Eleonora Ricci MD,

    1. From the Geriatric Research Group, Brescia, Italy
    2. Department of Rehabilitation and Aged Care, “Ancelle della Carità” Hospital, Cremona, Italy
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  • Fabio Guerini MD,

    1. From the Geriatric Research Group, Brescia, Italy
    2. Department of Rehabilitation and Aged Care, “Ancelle della Carità” Hospital, Cremona, Italy
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  • Giuseppe Bellelli MD,

    1. From the Geriatric Research Group, Brescia, Italy
    2. Department of Rehabilitation and Aged Care, “Ancelle della Carità” Hospital, Cremona, Italy
    3. Department of Prevention and Clinical Medicine, Milano-Bicocca University, Milan, Italy; and TorVergata University, Rome, Italy.
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  • Marco Trabucchi MD

    1. From the Geriatric Research Group, Brescia, Italy
    2. Department of Prevention and Clinical Medicine, Milano-Bicocca University, Milan, Italy; and TorVergata University, Rome, Italy.
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Address correspondence to Giuseppe Bellelli, Department of Prevention and Clinical Medicine, University of Milano-Bicocca, Milan, Italy. E-mail: giuseppe.bellelli@unimib.it

Abstract

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.

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