Impact of cognitive impairment on hip fracture outcome in older people

Hip fracture is common in older people and often leads to increased levels of disability and mortality and increased functional impairment. Cognitive impairment is also common and has been suggested to influence hip fracture outcome. This study evaluated the impact of cognitive impairment on functional outcome in older patients with femoral hip fracture, and patients' responses to a standard acute inpatient physiotherapy programme. Patients aged 65 years and older who underwent surgery for hip or upper femoral fracture were studied. Cognition was assessed using the Abbreviated Mental Test Score (AMTS) and mobility was measured using the Elderly Mobility Scale (EMS). Patient details and duration of physiotherapy treatment were recorded. Moderate to severe (although not mild to moderate) cognitive impairment had a strong negative impact on functional outcome and discharge, which was independent of the amount of physiotherapy received. An increased understanding of the complex relationship between cognition, ambulation and rehabilitation outcome is required and poses a significant challenge to health-care professionals.