title: Trajectories of Nutritional Status and Cognitive Impairment among Older Taiwanese with Hip Fracture.
abstract: This paper describes the trajectories of nutritional status and cognitive impairment and their correlation among older Taiwanese over 1 year after hip-fracture surgery.
  
  
  
  Secondary analysis of data from a clinical trial evaluating the effects of three types of post-discharge care for 292 older hip-fracture patients (age >60 years).
  
  
  
  Nutritional status was assessed by the Mini Nutritional Assessment before and 1, 3, 6, 12 months after hospital discharge. Cognitive function was measured by the Mini-Mental State Examination before surgery, at hospital discharge, 6 and 12 months after discharge. Trajectories of nutritional status and cognitive impairment were depicted by latent class growth modeling, whereas linkages between nutritional-status and cognitive-impairment trajectories were assessed by multinomial logistic regression.
  
  
  
  Nutritional status in general improved significantly, particularly during the first 3 months after discharge. We identified three trajectories of nutritional status: malnourished (15.4%), at risk for malnutrition (38.9%), and well-nourished (45.7%). In contrast, cognitive changes followed four largely linear but distinct trajectories: moderately impaired (12.2%), mildly impaired (27.8%), borderline impaired (21.8%), and cognitively intact (38.2%). Trajectories of nutritional status were significantly associated with cognitive-function trajectories. For instance, relative to malnourished patients, well-nourished patients were 95% less likely (OR=0.05, CI =0.01-0.24) to be moderately cognitively impaired.
  
  
  
  A good nutritional-status trajectory after hip fracture was associated with better cognitive function. To treat and care for elderly hip-fractured patients, specific interventions need to target those who are malnourished or at risk of malnutrition to decrease their risk for cognitive impairment.
authors.affiliation: Yea-Ing L. Shyu, Ph.D., School of Nursing, Chang Gung University, 259 Wenhua 1st Road, Guishan District, Taoyuan City 33302, Taiwan. Telephone: +886 3 211 8800 Ext. 5275, Fax: +886 3 211 8400, E-mail: yeaing@mail.cgu.edu.tw.
authors.forename: H P
authors.initials: HP
authors.lastname: Wang
authors.forename: J
authors.initials: J
authors.lastname: Liang
authors.forename: L M
authors.initials: LM
authors.lastname: Kuo
authors.forename: C Y
authors.initials: CY
authors.lastname: Chen
authors.forename: Y I L
authors.initials: YI
authors.lastname: Shyu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000150:complications*; D006801:Humans; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000150:complications; D008875:Middle Aged; D008962:Models, Theoretical; D015596:Nutrition Assessment; D009752:Nutritional Status; D010351:Patient Discharge; D012307:Risk Factors; D013624:Taiwan