Functional Outcome of Elderly Hip Fracture Patients is not Affected By Pre-Fracture Dementia.

OBJECTIVE: The aim of the study was to examine whether a diagnosis of pre-fracture Dementia (PFD) affects functional outcome at discharge from a geriatric rehabilitation setting.

DESIGN: A total of 211 consecutive elderly hip fracture patients were evaluated retrospectively. We used the Functional Independence Measure (FIM) and analyzed data by t-test, chi square-test and multiple linear regression analysis.

RESULTS: Patients with PFD were older (P = 0.001), presented with lower Mini-Mental State Examination (MMSE) scores (P < 0.001) and lower pre-fracture function (P < 0.001).Total-FIM and motor-FIM scores at admission and discharge, as well as FIM gain scores at discharge were lower among PFD patients, compared with non pre-fracture dementia (NPFD) patients (P < 0.001). FIM daily gains (Efficiency) (P < 0.001) and Montebello relative functional scores (P < 0.001) were also lower in PFD, compared with NPFD patients. However, linear regression analysis showed that PFD did not predict total, motor, or FIM gain at discharge (β=-0.11, P = 0.115; β=-0.06, P = 0.412; β=-0.099, p=0.329, respectively). Upon discharge, PFD patients achieved lower FIM scores yet maintained similar motor-FIM gains compared with NPFD patients.

CONCLUSIONS: Our study results supports the inclusion of PFD patients in post-fracture rehabilitation programs.