[The impact of cognitive impairment at admission on short-term functional outcome of elderly hip fracture patients].
BACKGROUND
The number of patents with dementia increases among hip fracture patients. Cognitive dysfunction is defined as a premorbid state which is potentionally negatively related to short-term functional outcome.


OBJECTIVE
To assess the relationship between cognitive status on admission and functional gain during an early rehabilitation period in elderly hip fracture patients.


METHODS
Forty-five elderly patients with surgically treated hip fracture were examined. Cognitive status was assessed by the Mini Mental State Examination (MMSE) at admission; functional status was assessed by the motor subscale of Functional Independence Measure (FIM) at admission and before discharge, while absolute functional gain was determined by the motor FIM gain (FIM discharge- FIM admission). Absolute functional gain was analyzed in respect to cognitive status.


RESULTS
Both cognitively impaired and cognitively intact hip fracture patients exhibited overall FIM motor improvements, as well as functional gains in specific FIM motor areas (p < 0.01). Absolute functional gain, however, was higher in 1) cognitively intact compared to cognitively impaired patients (p < 0.01), and 2) cognitively moderately impaired patients compared to severely cognitively impaired patients (p < 0.01). No difference in functional gain was detected between the patients with moderately cognitively impaired compared to the cognitive intact patients (p > 0.05).


CONCLUSIONS
The systematic use of MMSE identifies cognitively impaired hip fracture patients, and effectively predicts their short-term functional outcome. A higher admission cognitive status is related to a more favourable short-term rehabilitation outcome. In spite of cognitive impairment, elderly patients with hip fracture can benefit from participation in rehabilitation programmes. The systematic identification of cognitively impaired hip fracture patients at admission facilitates optimal treatment and rehabilitation, and thus enables the best achievable outcome to be reached.
Dubljanin-Racpopoć
Emilija
E
Matanović
Dragana
D
Bumbasirević
Marko
M
D000368:Aged; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis*; D005260:Female; D005265:Femoral Neck Fractures / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D020127:Recovery of Function; D016896:Treatment Outcome