Age and Ageing Advance Access originally published online on September 18, 2009
Age and Ageing 2009 38(6):686-692; doi:10.1093/ageing/afp169
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Gender differences and cognitive aspects on functional outcome after hip fracture—a 2 years’ follow-up of 2,134 patients
1 Division of Orthopaedics, Department of Clinical Science, Karolinska Institutet, Danderyd Hospital, SE-18288 Stockholm, Sweden
2 Department of Clinical Science, Intervention and Technology (Clintec), Karolinska Institutet, Karolinska University Hospital, 14186 Stockholm, Sweden
3 Division of Orthopaedics, Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset SE-11883 Stockholm, Sweden
4 Department of Orthopaedics, Visby General Hospital, SE-62184 Visby, Sweden
5 Department of Orthopedics, Lund University Hospital, SE-22185 Lund, Sweden
6 Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala Science Park, SE-75185 Uppsala, Sweden
7 Department of Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
Address correspondence to: B. Samuelsson, Sophiahemmet University College, Box 5605, SE-11486 Stockholm, Sweden. Tel: (+46) 704 176 973; Fax: (+46) 8 10 29 09. Email: bodil.samuelsson{at}shh.se
Background: hip fractures as well as cognitive dysfunction become increasingly prevalent in growing ageing populations. Hip fractures are approximately three times more common in elderly women.
Objective: we analysed outcome after hip fracture with respect to gender and cognitive function.
Design: population-based, prospective cohort study.
Setting: four university hospitals in Stockholm, Sweden.
Subjects: a total of 2,134 consecutive patients admitted with hip fracture during 2003.
Methods: gender differences in residence, walking ability and activity of daily living (ADL) were analysed at baseline, after 4 and 24 months in patients with and without intact cognitive function.
Results: women were older, more often living alone and had poorer walking ability (P < 0.001). Cognitive dysfunction was equally common by gender. Women were more often treated with a prosthesis (P < 0.001) and sent to rehabilitation (P < 0.001). In the cognitive dysfunction group, men had more co-morbidity (P < 0.001) and total loss of walking ability (P = 0.03), but more often resided in own homes (P = 0.03). There was no gender difference in ADL.
Conclusion: men had a higher risk for loss of walking ability and death only in patients with cognitive dysfunction. Cognitive function was the most important factor for returning to own home and regain pre-fracture function.
Keywords: hip fracture, gender differences, cognitive function, living conditions, walking ability, elderly
Received 19 February 2009; accepted in revised form 8 July 2009.