Functional dependence after hip fracture

Objectives: To identify patients at high risk of functional dependence and examine the progression of disability after a hip fracture. Design: This was a population-based prospective inception cohort study of a ll patients aged 65+ yr who fractured a hip between July 1996 and August 19 97. Demographic, socioeconomic, social support, and health status informati on was assessed in the hospital and 3 mo postfracture. Results: The analysis included 367 patients. Almost all patients with cogni tive impairment were functionally dependent postfracture, with new disabili ties frequently occurring in transferring. Among patients of high mental st atus, increased risk of functional dependence was associated with advanced age, more co-morbidities, hip pain, poor self-rated health, and previous em ployment in a prestigeous occupation. Bathing disability was most likely in those who functioned independently prefracture; a disability in dressing w as most common otherwise. Conclusion: Hip pain is amenable to treatment and may improve chances of fu nctional recovery. Patients can be assisted in regaining prefracture functi on if they are targeted for rehabilitation on the basis of mental status. T he focus should be on bathing and dressing among patients of high cognition and transferring among those patients with mental impairment.