COMORBIDITY IMPACT ON SOCIAL FUNCTIONING AFTER HIP FRACTURE: THE ROLE OF REHABILITATION

Rehabilitation Prognostic Factors following Hip Fractures Associated with Patient's Pre-Fracture Mobility and Functional Ability: A Prospective Observation Study

Low physical function is associated with poor outcomes in the elderly population suffering from hip fractures. The present study aims to evaluate the prognostic tools for predicting patient recovery after hip fractures and investigate the correlation between the pre-fracture motor and functional statuses. A prospective study was performed, including 80 patients suffering from hip fractures. Patient history, previous falls, the type of fracture and overall survival were evaluated. Patient-reported outcome measures (SF-36, EQ-5D/VAS, Charlson Comorbidity Index (CCI), Short Physical Performance Battery (SPPB), Timed Up and Go (TUG) and Harris Hip Score (HHS)) were monitored before hospital discharge at 6 weeks, and 3, 6 and 12 months postoperatively. Overall, 55% of patients experienced at least one fall, and 46% of them used crutches before the fracture. The average CCI score was 6.9. The SPPB score improved from 1.4 ± 1.3 (1 week) to 4.4 ± 2.1 (48 weeks). A one-year age increase, female sex, and prior history of falls lead to 0.1-, 0.92-, 0.56-fold lower SPPB scores, respectively, at 12 months. The HHS recorded the greatest improvement between 6 and 12 weeks (52.1 ± 14.6), whereas the TUG score continued to improve significantly from 139.1 ± 52.6 s (6 weeks) to 66.4 ± 54 s (48 weeks). The SPPB and performance test can be routinely used as a prognostic tool.

Sociodemographic Predictors of Physical Functioning in the Elderly: A National Health Survey

We aimed to evaluate the prevalence of sociodemographic factors with the presence and different degrees of walking difficulties in elderly above 65 years, and to analyze association between evaluated variables and the presence and degree of waking difficulties. In the population based study, 3540 individuals age above 65 years from Serbia were recruited. Further predictors were analyzed: gender, age, level of education, marital status, body mass index (BMI), index of well-being and place of residence. We assessed difficulty in walking half a km on level ground without the use of any aid (Group-1); and difficulty in walking up or down 12 steps (Group-2). Walking difficulties were categorized as no difficulty, some difficulty, a lot of difficulty and cannot do at all. For present difficulty significant predictors were: age (Group-1 (OR-3.022)/Group-2 (OR-3.825)), gender (Group-1 (OR-0.337)/Group-2 (OR-0.311)), educational level (Group-1 (OR-0.689)/Group-2 (OR-0.556)) and place of residence (Group-2 (OR-1.523)) while for non-performing the task, significant predictors were: age (Group-1 (OR-1.998)/Group-2 (OR-2.096)), gender (Group-1 (OR-0.629)/Group-2 (OR-0.495)), BMI (Group-1 (OR-1.219)/Group-2 (OR-1.305)), marital status (Group-1 (OR 0.764)/Group-2 (OR-0.769)), educational level (Group-1 (OR-0.679)/Group-2 (OR-0.719)) and index of well-being (Group-2 (OR-0.764)). Understanding of predictors, and their role on functional decline in elderly is of great importance for the development of specific population-based health programs to prevent further functional loss and preserve achieved functional gains.