title: Community-based rehabilitation post hospital discharge interventions for older adults with cognitive impairment following a hip fracture: a systematic review protocol.
abstract: BACKGROUND
  Hip fractures among older adults remain a public concern. Consequences of a hip fracture include the subsequent decline in function and mobility for the older adult, and an increased burden placed upon their caregivers and the health care system. The consequences may be more challenging if an older adult also has a compromised cognitive reserve. Although rehabilitation programs have proven effective, the best practices and resources required to maintain the gains in function and mobility, to negate diminution of effect, and to enable this patient population to continue living at home are currently unknown.
  
  
  OBJECTIVE
  The objective of this study is to develop a systematic review protocol focused on identifying the evidence and evaluating the effectiveness of post discharge rehabilitation programs for older adults with a cognitive impairment following a hip fracture.
  
  
  METHODS
  The search strategy will include a combination of text words and subject headings relating to the concepts of cognitive impairment, dementia, delirium, cognitive reserve, and hip fractures. Searching various databases will identify peer-reviewed journal articles. There will be two independent reviewers who will screen the titles and abstracts to determine which articles comprise a rehabilitation intervention within a community setting prior to being included for a full article review. A data extraction form and an evidence and quality checklist will be used during the full article data analysis and synthesis. It is expected that there will be a paucity of studies that focus on post discharge rehabilitation interventions for older adults with cognitive impairment following a hip fracture, and few studies that use the same or similar outcome measures. However, if possible, a meta-analysis will be conducted on studies that used similar outcome methods.
  
  
  RESULTS
  This review will synthesize knowledge focusing on activities to maintain and restore function in older adult patients with cognitive impairment once they have completed their active rehabilitation program and return home. A synthesis of the findings will be conducted to determine which components of the interventions identified were the most advantageous to the patient population. The results will be used to develop a multi-faceted post discharge rehabilitation intervention aimed at enabling older adults to return and remain living at home after a hip fracture.
  
  
  CONCLUSIONS
  The aim of this systematic review is to generate results that can be used to create interventions that focus on the care necessary to enable older adults to remain living at home post discharge from acute or inpatient rehabilitation care for a hip fracture. With the support and contributions by our associated knowledge users, this systematic review will be used to help inform procedures and policies to facilitate the necessary care and resources required by our patient population.
authors.affiliation: Department of Kinesiology, Faculty of Human Kinetics, The University of Windsor, Windsor, ON, Canada.
authors.forename: Paula M
authors.identifier: http://orcid.org/0000-0001-8452-5303
authors.initials: PM
authors.lastname: van Wyk
authors.forename: Charlene H
authors.identifier: http://orcid.org/0000-0002-0333-7210
authors.initials: CH
authors.lastname: Chu
authors.forename: Jessica
authors.identifier: http://orcid.org/0000-0002-4770-0579
authors.initials: J
authors.lastname: Babineau
authors.forename: Martine
authors.identifier: http://orcid.org/0000-0002-0710-1854
authors.initials: M
authors.lastname: Puts
authors.forename: Dina
authors.identifier: http://orcid.org/0000-0001-6080-5052
authors.initials: D
authors.lastname: Brooks
authors.forename: Marianne
authors.identifier: http://orcid.org/0000-0002-9261-5971
authors.initials: M
authors.lastname: Saragosa
authors.forename: Katherine S
authors.identifier: http://orcid.org/0000-0003-2470-9738
authors.initials: KS
authors.lastname: McGilton
keywords: at-home; cognitive impairment; community; hip fracture; intervention; rehabilitation