Effect of Dementia on Outcomes Following Surgically Treated
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Hip fractures are associated with increased mortality and functional limitations. This study examined the association of dementia with post-hip fracture mortality, permanent residential aged care entry, transition care use, and change in activities of daily living (ADL) needs.

It was decided to perform a retrospective cohort analysis. Individuals accessing aged care services who had a hip fracture were included in the study. The multivariable Cox, Fine-Gray, and logistic regression methods were used to estimate the associations of dementia with mortality, risks of transition and permanent treatment use, and progression of ADL needs.

Results:
--Of 4771 individuals evaluated, 76% were female, the median age was 86 years (IQR 82-90), and 71% already lived in permanent residential aged care at the time of fracture.

--Within two years of their hip fracture, 50.4% of individuals died, 16.2% entered a transition care program, 59.1% entered permanent residential aged care, and 32% had greater ADL needs.

--Dementia was associated with higher risk of two-year mortality (HR=1.19), 90-day entry into permanent care (sHR=1.96) and increased likelihood of ADL limitations (OR=1.36). Minor differences were seen in transition care use by dementia status.

To summarize, dementia is a significant risk factor for death after hip fractures in people living in nursing homes and is linked to a high risk of permanent treatment.

Source: https://www.sciencedirect.com/science/article/abs/pii/S0883540321004022?dgcid=rss_sd_all
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