Factors Associated with Recovered Functionality After Hip Fracture in Non-Institutionalized Older Adults: A Case-Control Study Nested in a Cohort

Abstract

Eliseo Ramírez-García,1 Guadalupe S García de la Torre,2 Erika Judith Rodríguez Reyes,3 Karla Moreno-Tamayo,1 María Claudia Espinel-Bermudez,4 Sergio Sánchez-García1 1Epidemiological and Health Services Research Unit, Aging Area, National Medical Center XXI Century, Instituto Mexicano del Seguro Social, Mexico City, Mexico; 2Public Health Department, School of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico; 3Epidemiological Surveillance Coordination, Instituto Mexicano del Seguro Social, Mexico City, Mexico; 4Clinical Epidemiology Research Unit, UMAE Specialties Hospital, Western Medical Center, Instituto Mexicano del Seguro Social, Guadalajara, MéxicoCorrespondence: Sergio Sánchez-García Email [email protected]: To identify factors associated with recovered functionality after a hip fracture in a sample of older adult patients.Patients and Methods: Nested case-control study in a cohort. Older adults (60 years or older) with a hip fracture were recruited between May 2017 and October 2018. The Barthel scale was used to measure performance in activities of daily living (ADL). A questionnaire was applied to collect information about demographic, clinic, psychological and social variables, and anthropometric measurements were taken. A logistic regression model was built to analyze various factors related to recovered functionality.Results: A total of 346 older adults with a hip fracture were studied (n=173 cases and n=173 controls); 69.4% (n=240) women and 30.6% (n=140) men. Mean age was 79.4 years (± 8.7) overall; for cases, 77.4 (± 7.9) years and for controls, 81.4 (± 9.0). Mean schooling was 6.3 (± 4.3) years. Recovered functionality was associated with normal nutritional status (OR 4.81, 95% CI = 2.54– 9.12), absence of heart disease (OR 4.08, 95% CI = 1.48– 11.20), self-efficacy for ADL (OR 4.07, 95% CI = 2.15– 7.72), absence of depressive symptoms (OR 2.99, 95% CI = 1.69– 5.28), prior functionality (OR 2.83, 95% CI = 1.51– 5.31), high socioeconomic level (OR 2.41, 95% CI = 1.24– 4.65) and transcervical fracture (OR 2.34, 95% CI = 1.05– 5.22).Conclusion: In older adults who have suffered a hip fracture, clinical, psychological, and demographic characteristics are associated with recovered functionality. These factors should be considered as a priority in the care of older adults who have experienced hip fractures.Keywords: functionality, hip fracture, older adults, case-control studies

Keywords

• functionality
• hip fracture
• older adults
• case-control studies