Low Recovery Rate for Hip Fractures in Older Adults

Despite efforts to provide rehabilitation, older adults who suffer hip fractures are less likely to fully recover to previous levels of function, according to recent study results (Journal of General Internal Medicine. 2016). 

“The likelihood of recovery to pre-fracture level of function was less than 50 percent regardless of one’s previous level of function,” Victoria Tang, lead author, said in a press release. “The likelihood of returning to a high level of function was particularly low in those who were older than age 85, had multiple comorbid conditions, or had dementia.”

Researchers assessed individuals who sustained a hip fracture and who were also enrolled in the Health and Retirement Study (HRS), a nationally representative longitudinal study that measures changes in the health and economic circumstances of Americans as they age. HRS conducts interviews every two years. Researchers used information from initial interviews preceding the fracture and from the first interview roughly six months following the fracture to determine the proportion of those who returned to pre-fracture function. 

The functional areas of interest researchers focused on were activities of daily living (ADL) dependency, mobility, and stair-climbing ability. In addition, researchers examined baseline characteristics associated with a return to ADL independence, walking one block, and climbing a flight of stairs.

According to the interview results, researchers identified 733 HRS hip fracture sufferers, aged 65 or older. Of those identified, 31% returned to their prior daily functioning; 34% and 41% were able to move and climb stairs as before, respectively. For subjects who were physically active prior to their injury, only 36% continued living independently without assistance, 32% had no difficulty walking one block, and 29% could climb stairs. For subjects aged 85 and older, returning to ADL independence was less likely following the injury. 

“Ascertainment of the patient’s values and goals of care is critical at this juncture in order to optimize quality of life and assist in future medical decision making,” said Ms Tang in a press release.—Julie Gould