Recovery from hip fracture in eight areas of function

Background. This report describes changes in eight areas of functioning aft er a hip fracture, identifies the point at which maximal levels of recovery are reached in each area, and evaluates the sequence of recuperation acros s multiple functional domains. Methods. Community-residing hip fracture patients (n = 674) admitted to eig ht hospitals in Baltimore, Maryland, 1990-1991, were followed prospectively for 2 years from the time of hospitalization. Eight areas of function (i.e ., upper and lower extremity physical and instrumental activities of daily living; gait and balance; social, cognitive, and affective function) were m easured by personal interview and direct observation during hospitalization at 2, 6, 12, 18, and 24 months. Levels of recovery are described in each a rea, and time to reach maximal recovery was estimated using Generalized Est imating Equations and longitudinal data. Results. Most areas of functioning showed progressive lessening of dependen ce over the first postfracture year, with different levels of recovery and time to maximum levels observed fur each area. New dependency in physical a nd instrumental tasks fur those not requiring equipment or human assistance prefracture ranged from as low as 20.3% for putting on pants to as high as 89.9% for climbing five stairs. Recuperation times were specific to area o f function, ranging from approximately 4 months fur depressive symptoms (3. 9 months), upper extremity function (4.3 months), and cognition (4.4 months ) to almost a year for lower extremity function (11.2 months). Conclusions. Functional disability following hip fracture is significant, p atterns of recovery differ by area of function, and there appears to be an orderly sequence by which areas of function reach their maximal levels.