title: Social predictors of recovery in late middle-aged and older persons after injury to the extremities: a prospective study.
abstract: OBJECTIVE
  The impact of educational level and social support on short-term and long-term recovery of activities of daily living and instrumental activities of daily living after injuries to the extremities was examined in a prospective study concerning late middle-aged and older persons.
  
  
  METHODS
  Patients (N = 171) who had sustained fall-related injuries (hip fractures, other fractures, or sprains and dislocations) participated in the study. Disability scores were collected at baseline (before the injury) and 8 weeks, 5 months, and 12 months after the injury. The authors used analysis of variance to assess possible differences between 3 levels of education and social support with respect to changes in disability scores from baseline to the 3 follow-up measurements while adjusting for covariates.
  
  
  RESULTS
  Preinjury assessed educational level or social support did not play a role in short-term changes in disability. In the long term (5 and 12 months after the injury), recovery was significantly associated with social support: Those with higher levels of support had a better recovery. Although patients with high levels of education most closely approached their pre-event level of disability as well, differences did not reach statistical significance. Short-term changes in disability appeared to be determined by the severity of the injury. Social support began to influence recovery only when the impact of severity expired.
  
  
  CONCLUSIONS
  Patients recovering from fall-related injuries who had reported high levels of social support before their injury had recovered better at 5 and 12 months. Encouragement and special attention given by health professionals to maintain social support may be beneficial for rehabilitation after fall-related injuries in older persons.
authors.affiliation: Department of Health Care Studies, Section of Medical Sociology, Maastricht University, The Netherlands. G.Kempen@zw.unimaas.nl
authors.forename: G I
authors.initials: GI
authors.lastname: Kempen
authors.forename: W
authors.initials: W
authors.lastname: Scaf-Klomp
authors.forename: A V
authors.initials: AV
authors.lastname: Ranchor
authors.forename: R
authors.initials: R
authors.lastname: Sanderman
authors.forename: J
authors.initials: J
authors.lastname: Ormel
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001134:Arm Injuries / Q000523:psychology / Q000534:rehabilitation*; D004522:Educational Status; D005260:Female; D006801:Humans; D007869:Leg Injuries / Q000523:psychology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012944:Social Support; D011795:Surveys and Questionnaires; D013997:Time Factors