Nutritional status, insulin-like growth factor-1 and quality of life in elderly women with hip fractures.
OBJECTIVE
To evaluate nutritional status and its relation to cognitive and physical function and quality of life in elderly female patients with hip fractures.


METHODS
Nutritional status was assessed in 42 women (80+/-7 years old) using the body mass index (BMI), triceps skin fold, arm muscle circumference and serum levels of insulin-like growth factor (IGF-1) and its binding protein (BP) IGFBP-1. Handgrip strength was measured. The Short Portable Mental Status Questionnaire was used to assess cognitive function and the Nottingham Health Profile to asses quality of life.


RESULTS
Low BMI (<== 20) and reduced IGF-1 and IGFBP-1 levels were detected in 50% of the patients. BMI correlated with IGF-1 (p<< 0.02) and with hand grip strength (P<< 0.001). Hand grip strength correlated with arm muscle circumference (P<< 0.05). Cognitive dysfunction was detected in 18% of the patients, and a correlation was found between cognitive function and BMI (P<< 0.01). The Nottingham Health Profile assessment indicated a lower quality of life in underweight patients as compared to others (P<< 0.05).


CONCLUSIONS
Half of the elderly women with hip fractures displayed signs of protein-energy malnutrition. Underweight was associated with reduced serum levels of IGF-1, muscle fatigue, cognitive dysfunction and a low quality of life rating, i.e. a cluster of factors which may unfavourably influence the postoperative course in a large proportion of hip fracture patients.
Ponzer
S
S
Department of Orthopaedics, Stockholm Söder Hospital, Stockholm, S-118 83, Sweden.
Tidermark
J
J
Brismar
K
K
Söderqvist
A
A
Cederholm
T
T
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003071:Cognition; D005069:Evaluation Studies as Topic; D005260:Female; D005593:Fracture Fixation, Internal; D006620:Hip Fractures / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D018969:Insulin-Like Growth Factor Binding Proteins / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D007361:Intelligence Tests; D009752:Nutritional Status; D015663:Osteoporosis, Postmenopausal / Q000150:complications; D011502:Protein-Energy Malnutrition / Q000209:etiology; D011788:Quality of Life; D012885:Skinfold Thickness
D018969:Insulin-Like Growth Factor Binding Proteins; D007334:Insulin-Like Growth Factor I