Disabilities and handicaps due to hip fractures in the elderly

Objective: to examine mortality, mobility, pain, institutionalization rates six month after hip fractures. Design: observational study, nonselected consecutive patients, time-set pro tocol. Setting: urban area (population n = 116,5000), five hospitals. Participants: hip fracture patients (n = 214), age 65 + years (mean 82.4 ye ars). Measurements: age, gender, prefracture status, operative procedures, compli cations, comorbidity, cognition (MMSE), depression (GDS), fear of falling, ADL (Barthel) and mobility and pain status (SAHFE protocol). Results: the incidence for this age group was 636.9/100,000, 31.8 % were in stitutionalized elderly. 84 % of the patients were female. Pre-existing com orbidity showed a high prevalence of neurodegenerative (cognitive deficits 53.6 %, Parkinson's disease/syndrome 11.2 %) and cerebrovascular diseases ( 16.8 %). Six months postfracture, the mortality was 17.6 %. From those surv iving 76.1% did walk indoors, 58.5 % did also walk outdoors. Independent to dress were 54.6 %. Severe pain was reported by 10.2 %, whereas 36.9 % desc ribed no pain. The institutionalization rate at six month was 19.0 %. Conclusions: the study showed considerable mortality, a significant loss in function and social disintegration. Considerable differences were observed for subgroups of patients, Future treatment should focus on risk stratific ation and include postdischarge training programs. Moreover, preventive str ategies should be implemented for high risk groups, such as ambulating pati ents with a history of stroke, Parkinson's disease and syndrome, dementia a nd nursing home residents.