Functional improvement of self-care in the elderly after hip fracture: is age a factor?
BACKGROUND
The aging population is growing rapidly in Asia resulting in an increased number of hip fractures being managed surgically. Though there is evidence of improved quality of patient care and outcomes with well-established models of care, we do not know if the functional recovery in activities of daily living among this group of patients is also dependant on age. We hypothesize that there will be a difference in Modified Barthel Index (MBI) scores between the 'older old' (>85 years) and the 'younger old' (<85 years).


METHODS
Hip fracture patients (>60 years) treated surgically were divided into Group A (below 85 years) and Group B (above 85 years). Demographic data, Charlson's Comorbidity Index (CCI) score, time to surgery and length of stay (LOS) were recorded. To assess the recovery in activities of daily living, the MBI scores were measured for the following intervals; pre-fall, at discharge, at 6-month and at 1-year follow-up.


RESULTS
The mean age for Group A (n = 120) was 77 years (60-85) and the mean age for Group B (n = 59) was 91.8 years (86-108). There was no significant difference in the mean CCI (A: 1.14, B: 1.24), mean time to surgery (A: 72.3 h, B: 79.9 h) and mean LOS (A: 10.8 days, B: 10.3 days). The MBI scores were significantly different (P < 0.05) for the pre-injury scores (A = 91.5, B = 84.4); however, there was no significant difference for scores measured at discharge (A = 57.5, B = 52.7), at 6 months (A = 74.6, B = 69.3) and at 1 year (A = 82.2, B = 73.2). Though there was a significant improvement, the scores at 1 year were significantly lower than the pre-injury score for both groups.


CONCLUSIONS
We conclude that age is not a factor in determining functional recovery with regard to activities of daily living in an integrated model of care for geriatric hip fracture patients.
Department of Orthopaedics and Traumatology, Tan Tock Seng Hospital, National Health Group, 11, Jalan Tan Tock Seng, Singapore, 308433, Singapore, sai_hkdoshi@yahoo.com.
Hitendra K
HK
Doshi
Rani
R
Ramason
Josephine
J
Azellarasi
Wai Lim William
WL
Chan
Ganesan
G
Naidu
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006620:Hip Fractures / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D016896:Treatment Outcome