期刊
ARCHIVES OF GERONTOLOGY AND GERIATRICS
卷 54, 期 3, 页码 E284-E289出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.archger.2011.08.013
关键词
Activities of daily living; Dementia; Hip fracture; Rehabilitation; Intervention
资金
- Vardal Foundation
- Joint Committee of the Northern Health Region of Sweden
- Swedish Dementia Foundation
- Foundation of the Medical Faculty, University of Umea
- County Council of Vasterbotten
- Swedish Research Council
- National Society for Research on Aging (RAF) in Sweden
Background: People with cognitive impairment and dementia have a poor outcome after a hip fracture surgery, about 30-50% of all those who sustain a hip fracture have dementia. Therefore the aim was to investigate whether a multidisciplinary postoperative intervention program could reduce postoperative complications and improve functional recovery among people with dementia. Methods: A randomized controlled trial with subgroup analyses among patients with dementia. Sixty-four patients with femoral neck fracture, aged >= 70 years at Umea University Hospital, Sweden. The intervention consisted of staff education, individualized care planning and rehabilitation, active prevention, detection and treatment of postoperative complications, especially delirium. The staff worked in teams to apply comprehensive geriatric assessment, management and rehabilitation, including a follow-up at 4 months postoperatively. The control group followed conventional postoperative routines. Results: There were fewer postoperative complications in the intervention group such as urinary tract infections, p = 0.001; nutritional problems, p = 0.025; postoperative delirium, p = 0.002; falls, p = 0.006. At 4 months a larger proportion in the intervention group had regained their previous independent indoor walking ability performance, p = 0.005. At 12 months a larger proportion in the intervention group had regained the activities of daily living (ADL) performance level they had before the fracture, p = 0.027. Conclusion: This study demonstrates that patients with dementia who suffer a hip fracture can benefit from multidisciplinary geriatric assessment and rehabilitation and should not be excluded from rehabilitation programs. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
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