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Predictors of functional recovery for hip fractured elders during 12 months following hospital discharge: a prospective study on a Taiwanese sample

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Abstract

To examine the longitudinal changes in overall and individual physical activities of daily living (PADLs) and instrumental activities of daily living (IADLs), at 1, 3, 6, and 12 months after hospital discharge in elderly subjects, 110 hip fractured elders (mean±SD age, 79.4±7.5; 60.9% females) were enrolled in a prospective study. At 12 months following hospital discharge, 56.1% subjects had recovered their overall PADLs, 37.9% had recovered their overall IADLs, and 74.2% could walk independently or with the aide of a cane. When analyzed by generalized estimating equations (GEE), for individual PADL, bathing and climbing stairs had consistently improved at every time point throughout the 1-year follow-up period, while transferring, toileting, and walking ability only improved significantly in the first 3 months after discharge. For individual IADL, the proportion of recovery for mobility appeared to increase significantly during the first 6 months post-discharge, and the remaining IADLs appeared to be stable. These results indicated that the recovery rate is varied for performance of different activities according to the complexity and the involvement of the lower extremities. We also found that less concomitant diseases, and a shorter hospital stay could predict a better recovery trend of overall and of most individual PADLs. These findings may be applicable to other countries with Chinese populations, and could provide a reference for health care providers to develop specific interventions for Chinese hip fractured elders.

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References

  1. Randell AG, Nguyen TV, Bhalerao N et al. (2000) Deterioration in quality of life following hip fracture: a prospective study. Osteoporos Int 11:460–466

    Article  CAS  PubMed  Google Scholar 

  2. Marottoli RA, Berkman LF, Cooney LM Jr (1992) Decline in physical function following hip fracture. J Am Geriatr Soc 40:861–866

    Google Scholar 

  3. Jette AM, Harris BA, Cleary PD et al. (1987) Functional recovery after hip fracture. Arch Phys Med Rehabil 68:735–740

    CAS  PubMed  Google Scholar 

  4. Katz S, Ford AB, Heilpe KG et al. (1964) Studies of illness in the aged: recovery after fracture of the hip. J Gerontol 19:285–293

    CAS  PubMed  Google Scholar 

  5. Kreulzfeldt J, Haim M, Bach E (1984) Hip fracture among the elderly in a mixed urban and rural population. Age Ageing 13:111–119

    PubMed  Google Scholar 

  6. Thomas TG, Steven RS (1974) Social effects of fracture of the neck of the femur. BMJ 3:456–458

    CAS  PubMed  Google Scholar 

  7. Jensen JS, Tøndevold E, Sørensen PH (1980) Costs of treatment of hip fractures. Acta Orthop Scand 51:289–296

    CAS  PubMed  Google Scholar 

  8. Cobey JC, Cobey JH, Conant L et al. (1976) Indicators of recovery from fractures of the hip. Clin Orthop 117:258–262

    PubMed  Google Scholar 

  9. Mossey JM, Mutran E, Knott K et al. (1989) Determinants of recovery 12 months after hip fracture: the importance of psychosocial factors. Am J Pub Health 79:279–286

    CAS  PubMed  Google Scholar 

  10. Jensen JS, Bagger J (1982) Long-term social prognosis after hip fractures. Acta Orthop Scand 53:97–101

    CAS  PubMed  Google Scholar 

  11. Magaziner J, Simonsick EM, Kashner TM et al. (1990) Predictors of functional recovery one year follow hospital discharge for hip fracture: a prospective study. J Gerontol 45:M101–107

    CAS  PubMed  Google Scholar 

  12. Norton R, Butler M, Robinson E et al. (2000) Declines in physical functioning attributable to hip fracture among older people: a follow-up study of case-control participants. Disabil Rehabil 22:345–351

    Article  CAS  PubMed  Google Scholar 

  13. Tsai YJ, Lin HS, Chow LP (1995) A pilot study on health sector priority review in Taiwan: by retrospective study on the elderly hip fracture (monograph). Taiwan Provincial Institute of Family Planning, Taichung, Taiwan

    Google Scholar 

  14. Manpower Planning Department, Council for Economic Planning and Development, Executive Yuan, Republic of China (1996) Projections of the population of Taiwan area, Republic of China 1995 to 2036. The Department, Taipei, Taiwan

  15. Young Y, Brant L, German P et al. (1997) A longitudinal examination of functional recovery among older people with subcapital hip fractures. J Am Geriatr Soc 45:288–294

    Google Scholar 

  16. Nickens HW (1983) Reviews of factors affecting occurrence and outcome of hip fracture, with special reference to psychosocial issues. J Am Geriatr Soc 31:166–170

    Google Scholar 

  17. Peterson MGE, Allegrante JP, Cornell CN et al. (2002) Measuring recovery after a hip fracture using the SF-36 and Cummings Scales. Osteoporos Int 13:296–302

    Article  Google Scholar 

  18. Barnes B, Dunovan K (1987) Functional outcomes after hip fracture. Phys Ther 67:1675–1679

    CAS  PubMed  Google Scholar 

  19. Chin K, Evans MC, Cornish J et al. (1997) Differences in hip axis and femoral neck length in premenopausal women of Polynesian, Asian and European origin. Osteoporos Int 7:344–347

    CAS  PubMed  Google Scholar 

  20. Launer LJ, Harris T (1996) Weight, height and body mass index distributions in geographically and ethnically diverse samples of older persons. Ad Hoc Committee on the Statistics of Anthropometry and Aging. Age Ageing 25:300–306

    CAS  PubMed  Google Scholar 

  21. Wang MC, Aguirre M, Bhudhikanok GS et al. (1997) Bone mass and hip axis length in healthy Asian, black, Hispanic, white American youths. J Bone Miner Res 12:1922–1935

    CAS  PubMed  Google Scholar 

  22. Wang J, Thornton JC, Russell M et al. (1994) Asians have lower bone mass index (BMI) but higher percent body fat than do white: comparisons of anthropometric measurements. Am J Clin Nutr 60:23–28

    CAS  PubMed  Google Scholar 

  23. Magaziner J, Simonsick EM, Kashner TM et al. (1988) Patient-proxy response comparability on measures of patient health and functional status. J Chin Epidemiol 41:1065–1074

    CAS  Google Scholar 

  24. Chen YJ, Dai YT, Yang CT et al. (1995) A review and proposal on patient classification in long-term care system. Department of Health, Republic of China, Taipei, Taiwan

  25. Lawton MP, Brody E (1969) Assessment of older people, self-maintaining and instrumental activities of daily living. Gerontologist 9:179–188

    CAS  PubMed  Google Scholar 

  26. Liang KY, Zeger SL (1986) Longitudinal data analysis using generalized linear models. Biometrika 73:13–22

    Google Scholar 

  27. Liang KY, Zeger SL (1993) Regression analysis for correlated data. Annu Rev Public Health 14:43–68

    Article  CAS  PubMed  Google Scholar 

  28. Ceder L, Thorngren KG, Wallden B (1980) Prognostic indicators and early home rehabilitation in elderly patients with hip fracture. Clin Orthop 152:173–184

    PubMed  Google Scholar 

  29. Kane RA, Kane RL (1981) Assessing the elderly: a practical guide to measurement. Lexinton Books, Toronto

    Google Scholar 

  30. Wu SC, Hsu HC, Chuang YC, Chang MC (1996) Application of functional assessment in estimating long-term care need among non-institutionalized elderly adults in Taiwan. Chin J Public Health 15:533–544

    Google Scholar 

  31. Nickens HW (1983) Review of factors affecting occurrence and outcome of hip fracture, with spherical reference to psychosocial issues. J Am Geriatr Soc 31:166–170

    Google Scholar 

  32. Williams DR, Wilson CM (2001) Race, ethnicity, and aging. In: Binstock RG, George LK (eds) (2001) Handbook of aging and the social sciences (5th edn). Academic Press, San Diego, pp 160–178

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Acknowledgment

This work was funded by the National Health Research Institute, Republic of China.

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Authors and Affiliations

  1. Center for Gerontological Research, Chang Gung University, 259 Wen-Hua 1st Road, Kwei-Shan, Tao-Yuan 333, Taiwan, ROC

    Yea-Ing Lotus Shyu

  2. School of Nursing, Chang Gung University, 259 Wen-Hua 1st Road, Kwei-Shan, Tao-Yuan 333, Taiwan, ROC

    Yea-Ing Lotus Shyu

  3. Department of Public Health, Chang Gung University, 259 Wen-Hua 1st Road, Kwei-Shan, Tao-Yuan 333, Taiwan, ROC

    Min-Chi Chen

  4. Health Management and Policy, School of Public Health, University of Michigan, M3234 School of Public Health II, Ann Arbor, MI 48109-2029, USA

    Jersey Liang

  5. Department of Orthopedics, Chang Gung Memorial Hospital, 5 Fu-Hsin Street, Kwei-Shan, Tao-Yuan 333, Taiwan, ROC

    Chi-Chuan Wu

  6. Department of Trauma & Emergency Surgery, Chang Gung Memorial Hospital, 5 Fu-Hsin Street, Kwei-Shan, Tao-Yuan 333, Taiwan, ROC

    Juin-Yih Su

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  1. Yea-Ing Lotus Shyu
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  2. Min-Chi Chen
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  3. Jersey Liang
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Correspondence to Yea-Ing Lotus Shyu.

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Shyu, YI.L., Chen, MC., Liang, J. et al. Predictors of functional recovery for hip fractured elders during 12 months following hospital discharge: a prospective study on a Taiwanese sample. Osteoporos Int 15, 475–482 (2004). https://doi.org/10.1007/s00198-003-1557-2

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  • DOI: https://doi.org/10.1007/s00198-003-1557-2

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