Background Surgical procedures enable for some of the patients with osteoporotic hip fracture early mobilisation and satisfactory functional recovery. Cognitive and emotional disorders which accompany old age can interfere with the outcome of the threatment.
Objectives The aim of this study was to compare levels of functional recovery of patients after surgicaly treated osteoporotic hip fracture depending on associated diseases, cognitive and emotional disorders.
Methods In this study included 30 patients with surgicaly treated osteoporotic hip fracture. The first group included patients with lower mental abilities (moderate and mild dementia), while the second group included patients with intact mental abilities. For assesing the presence of depressive symptomatology was used Cornel scale of depresion in dementia. All patients were included in program of medical rehabilitation according to certain protocols. Functional abilities of all patients were assesed with Functional impairment measurement test (FIM).
Results For the functional abilities (self-care, sphincter mobility, movement, communication and socialization) used the multivariate analysis of variance: group (between subjects effect) Wilks’ Lambda =0.251 F =1303.846 df (6.53) p<0,001; treatment (within subjects effect) Wilks’ Lambda =0.084 F =118.399 df (5.54) p<0,001; interaction (treatment group) Wilks’ Lambda =0.373 F =18.124 df (5.54) p<0,001. That both groups of patients had improved in functional recovery, but patients with dementia had worse functional recovery than patients without dementia. Demented patients are the biggest problem of memory disorders, language and visuospatial functions, attention and behavior disorders. For comparison groups according to the presence of depressive disorder used a one-way analysis of variance: signs related to mood F =23.417 df (2) p<0,001; behavioral disorders F =26.069 df (2) p<0,001; physical signs of F =14.706 df (2) p<0,001; the cyclic function F =22.468 df (2) p<0,001; cornell index total F =98.960 df (2) p<0,001. The impact of cognitive impairment is reflected in poorer self-care activities, poorer mobility and gait. Depression affects the agility of functional recovery, and leads to less functionality in patients with cognitive disorders. Emotional disorders are associated with neuropsychological dysfunctions and more influence on the ability of social interaction.
Conclusions Our study confirmed negative impacts of cognitive and emotional disorders on functional recovery of the patients after surgicaly treated hip fracture.The impact of cognitive deficits in functionality is more pronounced than the impact of depression and associated illnesses.
Givens JL, Sanft TB, Marcantonio ER. J Am Geriatric Society 2008;56:1075–1079
Hallberg I, Rosenqvist AM, Kartous L, Lofman O, Wahlstom O, Toss G. Osteoporosis International 2004;15:834–841
Hawkes WG, Wehren L, Orwig D, Hebel JR, Magaziner J. Journal of Gerontology 2006;61(5):495–499
Lin PC, Chang SY. Journal of Nursing Research 2004;12(1):72–82
Disclosure of Interest None Declared