title: Brain atrophy evaluated by computed tomography in independent and institutionalized hip fracture patients.
abstract: OBJECTIVE
  To examine if there is an association between brain computed tomography (CT) findings and place of residence in a series of hip fracture patients.
  
  
  METHODS
  The CT scans taken immediately after hip fracture of 215 patients (mean age 81.6 years) living in their own homes or otherwise independently (home-dwelling group) and 95 patients (mean age 82.5 years) permanently institutionalized (institutionalized group) were analysed.
  
  
  RESULTS
  The institutionalized patients had significantly more cortical cerebral (frontal, p = 0.004; temporal, p = 0.007; parietal, p < 0.001) and central cerebral (third ventricle width, p < 0.001; frontal horn width, p < 0.001; midbody width, p < 0.001) atrophy than the home-dwelling ones. This was also true of atrophy in the white-matter (WM) area (p < 0.001). The institutionalized patients also had more atrophy of the cerebellar hemisphere (atrophy of the cerebellopontine angle cistern, p = 0.002, greater fourth ventricle width, p = 0.020). No significant difference was seen in the incidence of brain infarcts.
  
  
  CONCLUSIONS
  Hip fracture patients living in institutions have more brain atrophy than those living independently. The brain atrophy may be one factor in the multiple mechanism underlying their institutional admission.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, University Hospital of Oulu, Kajaanintie, Finland.
authors.forename: R
authors.initials: R
authors.lastname: Sakone
authors.forename: J
authors.initials: J
authors.lastname: Pyhtinen
authors.forename: E
authors.initials: E
authors.lastname: Pääkkö
authors.forename: H
authors.initials: H
authors.lastname: Vähänikkilä
authors.forename: J
authors.initials: J
authors.lastname: Ristiniemi
authors.forename: P
authors.initials: P
authors.lastname: Jalovaara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000473:pathology; D006620:Hip Fractures / Q000000981:diagnostic imaging*; D006801:Humans; D007326:Institutionalization; D008297:Male; D008875:Middle Aged; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed