Abstract

ADAM, S; GODLWANA, L  and  MALEKA, D. Changes in short-term cognitive function following a hip fracture in the elderly and the effect of cognitive function on early post-operative function. SA orthop. j. [online]. 2016, vol.15, n.1, pp.77-82. ISSN 2309-8309.  https://doi.org/10.17159/2309-8309/2016/v15n1a9.

OBJECTIVE: To evaluate the changes in short-term cognitive function and the relation between cognition and early post-operative functional outcome in the elderly following a hip fracture DESIGN: Prospective pre-test-post-test observational study SETTING: Two public hospitals in Johannesburg, South Africa PARTICIPANTS: Ninety elderly patients with a first time unilateral hip fracture over the age of 60 years were consecutively sampled. Patients with polytrauma and those with co-morbidities affecting mobility (stroke, Parkinson's disease or a spinal cord injury) were excluded. Patients re-admitted with complications of a previous surgery or those managed conservatively were also excluded. Seventy-two participants completed the study DATA COLLECTION: Pre-operative (baseline), discharge and six weeks post discharge assessments were carried out. Cognitive function was established using the Six-Item Cognitive Impairment Test (6CIT) at each of the three assessment periods. The participants' post-operative functional level was assessed using the Elderly Mobility Scale (EMS) and the Lower Extremity Functional Scale (LEFS) at discharge and at six weeks post discharge RESULTS: This study revealed significant advances in cognition from baseline to six weeks post discharge (z-statistic -5.04, p=0.000). After adjusting for pre-fracture functional mobility and pre-existing co-morbidities, a multivariate regression analysis revealed that cognitive function is also a strong predictor of early post-operative functional outcome (β= -0.14, p=0.036 CONCLUSION: Cognitive function in elderly individuals with a hip fracture does improve over time. Cognitive function is a strong predictor of early post-operative functional outcome, when adjusted for pre-fracture functional mobility and pre-existing co-morbidities

Keywords : hip fracture; elderly; cognitive function; early post-operative functional outcome; Six-Item Cognitive Impairment Test.

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