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Hip fracture and the influence of dementia on health outcomes and access to hospital-based rehabilitation for older individuals

MITCHELL R; HARVEY L; BRODATY H; DRAPER B; CLOSE J
DISABIL REHABIL , 2016, vol. 38, n° 23, p. 2286-2295
Doc n°: 183327
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.3109/09638288.2015.1123306
Descripteurs : MA - GERONTOLOGIE, DA43 - FRACTURES, HC1 - STRUCTURES - ETABLISSEMENT SERVICE DE SOINS

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. METHOD: 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. RESULTS: 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. CONCLUSION:
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.

Langue : ANGLAIS

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