4.6 Article

Changes in functional status attributable to hip fracture: A comparison of hip fracture patients to community-dwelling aged

Journal

AMERICAN JOURNAL OF EPIDEMIOLOGY
Volume 157, Issue 11, Pages 1023-1031

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwg081

Keywords

activities of daily living; aging; disability evaluation; disabled persons; hip fractures

Funding

  1. NIA NIH HHS [R37 AG09901, R01 AG06322, R01 AG18037] Funding Source: Medline
  2. NICHD NIH HHS [R01 HD0073] Funding Source: Medline

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Disability attributable to hip fracture regarding activities of daily living was evaluated by comparing 594 hip fracture patients entering eight hospitals in Baltimore, Maryland, in 1990-1991 with community-dwelling aged from the Established Populations for Epidemiologic Studies of the Elderly (EPESE) cohort matched on age, sex, and walking ability. Subjects were assessed at baseline (prefracture report for patients), 12 months, and 24 months. At baseline, 26% of both groups had walking disability, 12-14% had transferring disability, and 6-8% evidenced grooming disability. At 12 and 24 months, about 50% of hip fracture patients were walking disabled compared with 21-29% of EPESE respondents after the authors controlled for age, sex, comorbidities, and functional status (excess disability attributable to hip fracture, i.e., attributable disability, of 26 additional cases of disability per 100 persons in the hip fracture cohort during follow-up). Likewise, hip fracture patients experienced more disability regarding transferring (38-39% vs. 10-18%; attributable disability, approximately 22 cases per 100 persons) and grooming (17-19% vs. 7-15%; attributable disability, approximately six cases per 100 persons). Thus, results showed that hip fracture patients had substantially more activities of daily living disability than that explained by aging over 24 months.

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