Hip fracture in nursing homes: An Italian study on prevalence latency, risk factors, and impact on mobility

Hip fracture may cause and/or complicate institutionalization. We undertook this study to define its overall prevalence among the residents of four nu rsing homes in Central Italy as well as its latency and impact on mobility when it occurred within institutions. We also performed a case control anal ysis with the aim of identifying potential risk factors for hip fracture in nursing home. Among the 211 residents (160 women, mean age 82.2 +/- 9.29 y ears, and 51 men, mean age 77.1 +/- 8.9 years), 42 were hip fracture cases, with a prevalence of almost 20%, and a female/male ratio of 6/1.23 fractur es preceded institutionalization; of these 19 (17 females and 2 males) occu rred within the nursing homes (mean age 83.2 +/- 6.3 years). The average in terval between institutionalization and fracture was 74.2 months. The impac t of hip fracture on mobility was relevant. The percentage of residents amb ulating autonomously fell from 95% to 32% among those who had fractured. Fr actured subjects were characterized by worse mobility and function than unf ractured subjects, while comorbidity, cognitive functions, and use of psych otropic drugs were similar. Prefracture mobility of fractured subjects was better than that of age-and sex-matched residents who had never fractured t heir hip. Regarding hip fracture in our nursing home population we can conc lude that (1) hip fracture is one of the main causes of institutionalizatio n; (2) in most cases hip fracture occurred late in the course of the nursin g home stay; (3) the functional impact of the fracture was relevant when it occurred in institutions. We also suggest that preserved mobility may repr esent an additional risk factor for hip fracture in nursing homes.