title: Rehabilitation of older adults with hip fracture: cognitive function and walking abilities.
abstract: OBJECTIVE
  To investigate the association between baseline cognitive function and the achievement of walking independence and its maintenance at 1 year in a population of older adults who underwent post-hip fracture (HF) surgery rehabilitation.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Department of rehabilitation and aged care.
  
  
  METHODS
  Three hundred six older adults admitted for post-HF surgery rehabilitation.
  
  
  METHODS
  All participants aged 65 and older who were completely unable to walk on admission but able to walk before fracture were stratified according to Mini-Mental State Examination score (0-15=moderately severe or severe cognitive impairment (CI), 16-23=mild to moderate CI, ≥24=no CI). Walking ability was defined according to the corresponding Barthel Index subitem, with walking independence at discharge being defined as a score of 12 or more out of 15. Walking ability 1 year after discharge was ascertained by telephone interviews with participants or proxies.
  
  
  RESULTS
  At discharge, 29.6% of participants with moderately severe or severe CI (n=24), 51.9% with mild to moderate CI (n=56) and 78.6% of participants without CI (n=92) were able to walk independently. Among those who achieved walking independence and were alive at 1 year, 12 participants with moderately severe or severe CI (57.1%), 31 with mild to moderate CI (57.7%) and 73 without CI (78.9%) were still capable of walking independently.
  
  
  CONCLUSIONS
  Although less frequently than in individuals with better cognitive function, walking independence is achievable after HF surgery rehabilitation, and can be maintained at 1 year also in those with moderately severe or severe CI.
authors.affiliation: Geriatric Research Group, Brescia, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Morghen
authors.forename: Simona
authors.initials: S
authors.lastname: Gentile
authors.forename: Eleonora
authors.initials: E
authors.lastname: Ricci
authors.forename: Fabio
authors.initials: F
authors.lastname: Guerini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bellelli
authors.forename: Marco
authors.initials: M
authors.lastname: Trabucchi
mesh_terms: D000203:Activities of Daily Living / Q000145:classification; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000150:complications* / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006620:Hip Fractures / Q000453:epidemiology* / Q000534:rehabilitation*; D006801:Humans; D007558:Italy; D008297:Male; D008609:Mental Status Schedule / Q000706:statistics & numerical data; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D011594:Psychometrics; D012047:Rehabilitation Centers; D016138:Walking