Rehabilitation outcome of elderly patients with hip fracture and cognitive impairment.
OBJECTIVE
To assess the association between cognitive status and functional gain during a rehabilitation programme for elderly patients with hip fracture.


METHODS
Prospective study in a hospital geriatric rehabilitation unit. Sixty-one consecutive patients were studied: 28 with cognitive impairment (age 87.6 +/- 7.2 years, Mini Mental State Examination (MMSE) score 11.25 +/- 5.9), 23 with possible cognitive impairment (age 83.9 +/- 6.8 years, MMSE 22.65 +/- 1.6) and 10 without cognitive impairment (age 77.6 +/- 7.4 years, MMSE 29.5 +/- 0.9). Cognitive status was assessed with the MMSE and admission and discharge functional status with the Functional Independence Measure (FIM). Functional gain was calculated by absolute FIM gain (admission FIM minus discharge FIM), relative (to maximum potential) FIM gain with the Montebello Rehabilitation Factor Score (MRFS) and analysis of covariance of the FIM (ANCOVA).


RESULTS
Patients without cognitive impairment had significantly higher admission FIM and discharge FIM. Cognitive status was not significantly associated with absolute functional gain. The adjusted (age, gender, sensory impairment, nutritional status, comorbidity and treatment) MRFS score of cognitively impaired patients was significantly lower (p < 0.03). However, the functional gain related to baseline functional status (ANCOVA) was not significantly different between the groups.


CONCLUSIONS
In spite of cognitive impairment, elderly patients with hip fracture can benefit from participation in rehabilitation programmes.
Rolland
Yves
Y
Service de Médecine Interne et de Gérontologie Clinique, Hôpital La Grave-Casselardit, Toulouse, France. yves.rolland@9online.fr
Pillard
Fabien
F
Lauwers-Cances
Valérie
V
Busquère
Florence
F
Vellas
Bruno
B
Lafont
Christine
C
D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D016896:Treatment Outcome