Journal
AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY
Volume 26, Issue 11, Pages 1119-1127Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jagp.2018.07.001
Keywords
Hip fracture; delirium; cognitive decline
Categories
Funding
- NIMH [R01 MH074596]
- Washington University Institute of Clinical and Translational Sciences from the National Center for Advancing Translational Sciences of NIH [UL1TR000448]
- Taylor Family Institute for Innovative Psychiatric Research
- Center for Brain Research in Mood Disorders (Washington University)
- NIH
- U.S. Food and Drug Administration
- McKnight Brain Research Foundation
- Barnes-Jewish Foundation
- Alkermes
- Takeda
- Lundbeck
- Janssen
- Patient-Centered Outcomes Research Institute
- Centers for Disease Control and Prevention
- U.S. Department of Housing and Urban Development
- ACL
- Toto
- NIMH
- Sidney R. Baer, Jr., Foundation
- Center for Brain Research in Mood Disorders at Washington University
- Otsuka America, Inc.
- Shire
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Objective: We examined cognitive function in nondemented, nondelirious older adults 1 year post hip fracture. Design: Prospective observational study. Setting and Participants: Three hundred eighty-six hip fracture patients aged 60 years and older with no history of cognitive impairment, such as clinical dementia or persistent delirium, recruited from eight area hospitals 2-3 days after hip surgery (week 0), and 101 older adults with no recent acute medical events for control comparison. Methods: Cognitive function was examined with the Repeatable Battery for the Assessment of Neuropsychological Status and the Short Blessed Test (SBT) at weeks 0 (SBT only), 4, and 52 using a repeated measures mixed model analysis. Baseline predictor variables included demographics, personality, genetic factors, and depressive symptom level. Results: Hip fracture participants had lower cognitive scores than healthy comparisons. Cognitive scores improved in the hip fracture group relative to healthy comparison participants from week 4-52. The only significant predictor of cognitive improvement after hip fracture was education: individuals with college education showed cognitive improvement by week 52, while those with high school or less did not. Conclusion: Nondemented, nondelirious older adults suffering hip fracture have poorer cognitive function immediately after the fracture but then exhibit cognitive improvement over the ensuing year, especially among those with high education. This demonstrates brain resilience in older adults even in the context of advanced age, medical illness, and frailty.
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