How much do combined affective and cognitive impairments worsen rehabilitation outcomes after hip fracture ?

BMC Geriatrics

Table 1 Characteristics of patients admitted to rehabilitation after surgery for a hip fracture

Characteristics	Patients with hip fracture (n = 612)
Age (years, mean ± SD)	84.1 ± 6.9
Women (%)	78.3
Living alone prior to hospitalization (%)	67.2
Formal home care prior to hospitalization (%)	50.6
Number of comorbidities (mean ± SD)	6.9 ± 3.7
Instrumental^a ADL score prior to hospitalization (mean ± SD)	5.3 ± 2.5
Basic ADL^b score prior to hospitalization (mean ± SD)	5.3 ± 1.0
Basic ADL^b score at admission (mean ± SD)	2.1 ± 1.3
Barthel Index score ^c at admission (mean ± SD)	53.0 ± 17.2
MMSE^d score (mean ± SD)	24.1 ± 5.5
GDS score^e (mean ± SD)	3.0 ± 2.7
Mental status^f:
-No cognitive, no affective impairment (%)	58.3
-Affective impairment only (%)	8.2
-Cognitive impairment only (%)	27.5
-Combined cognitive and depressive impairments (%)	7.5

^a Lawton’s scale for instrumental activities of daily living [25]. Include ability to use telephone, shopping, food preparation, housekeeping, laundry, use of public transportation, and ability to handle medications and money. Scores range from 0 to 8, with higher scores indicating higher function
^b Katz’ Basic Activities of Daily Living [24]. Include bathing, dressing, using the toilet, transferring between bed and chair, maintaining continence, feeding. Scores range from 0 to 6, with higher scores indicating higher function
^c Barthel Index: score ranges from 0 to 100, with higher score indicating better mobility and functional performances [26]
^d Based on Folstein’s Mini Mental Status Examination [27]. Scores range from 0 to 30, with a score < 24/30 indicating cognitive impairment
^e Based on the Geriatric Depression Scale, short form (15 items) [28]. Affective impairment defined as a score of 6 or more
^f Based on score at the MMSE and GDS instruments, patients were classified as 1) no cognitive, no affective impairment; 2) affective impairment only; 3) cognitive impairment only; 4) combined cognitive and affective impairments

ISSN: 1471-2318