title: Hip fracture and the influence of dementia on health outcomes and access to hospital-based rehabilitation for older individuals.
abstract: For older individuals who sustain a hip fracture, the presence of dementia can influence their access to hospital-based rehabilitation.
  
  
  
  This study compares the characteristics and health outcomes of individuals with and without dementia following a hip fracture; and access to, and outcomes following, hospital-based rehabilitation in a population-based cohort.
  
  
  
  An examination of hip fractures involving individuals aged 65 years and older with and without dementia using linked hospitalisation, rehabilitation and mortality records during 2009-2013.
  
  
  
  There were 8785 individuals with and 23 520 individuals without dementia who sustained a hip fracture. Individuals with dementia had a higher age-adjusted 30-d mortality rate compared to individuals without dementia (11.7% versus 5.7%), a lower proportion of age-adjusted 28-d re-admission (17.3% versus 24.4%) and a longer age-adjusted mean length of stay (22.2 versus 21.9 d). Compared to individuals without dementia, individuals with dementia had 4.3 times (95% CI: 3.90-4.78) lower odds of receiving hospital-based rehabilitation. However, when they did receive rehabilitation they achieved significant motor functional gain at discharge compared to admission using the Functional Independence Measure, but to a lesser extent than individuals without dementia.
  
  
  
  Within a population-based cohort, older individuals with dementia can benefit from access to, and participation in, rehabilitation activities following a hip fracture. This will ensure that they have the best chance of returning to their pre-fracture physical function and mobility. Implications for Rehabilitation Older individuals with dementia can benefit from rehabilitation activities following a hip fracture. Early mobilisation of individuals post-hip fracture surgery, where possible, is advised. Further work is needed on how best to work with individuals with dementia after a hip fracture in residential aged care to maximise any potential functional gains.
authors.affiliation: a Australian Institute of Health Innovation, Macquarie University , North Ryde, Australia ;|b Falls and Injury Prevention Group , Neuroscience Research Australia, University of New South Wales , Randwick, Australia ;
authors.forename: Rebecca
authors.initials: R
authors.lastname: Mitchell
authors.affiliation: b Falls and Injury Prevention Group , Neuroscience Research Australia, University of New South Wales , Randwick, Australia ;
authors.forename: Lara
authors.initials: L
authors.lastname: Harvey
authors.affiliation: c Dementia Collaborative Research Centre - Assessment and Better Care, University of New South Wales , Kensington, Australia ;|d Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales , Kensington, Australia ;
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
authors.affiliation: c Dementia Collaborative Research Centre - Assessment and Better Care, University of New South Wales , Kensington, Australia ;|d Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales , Kensington, Australia ;
authors.forename: Brian
authors.initials: B
authors.lastname: Draper
authors.affiliation: b Falls and Injury Prevention Group , Neuroscience Research Australia, University of New South Wales , Randwick, Australia ;|e Prince of Wales Clinical School , University of New South Wales , Kensington, Australia.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Close
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000150:complications* / Q000401:mortality; D005260:Female; D006620:Hip Fractures / Q000150:complications* / Q000534:rehabilitation*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D012042:Registries; D012189:Retrospective Studies
keywords: Dementia; hip fracture; hospitalisation; older adults