An 11-year review of hip fracture hospitalisations, health outcomes, and predictors of access to in-hospital rehabilitation for adults ≥ 65 years living with and without dementia:​ a population-based cohort study

Mitchell, R.; Draper, B.; Brodaty, H.; Close, J.; Ting, H. P.; Lystad, R.; Harris, I.; Harvey, L.; Sherrington, C.; Cameron, I. D.; Braithwaite, J.

Affiliations

¹Australian Institute of Health Innovation, Macquarie University, Sydney, Australia

²Dementia Collaborative Research Centre - Assessment and Better Care, University of New South Wales, Sydney, Australia

³Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Australia, Sydney, Australia

⁴Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, Australia

⁵Prince of Wales Clinical School, University of New South Wales, Sydney, Australia

⁶Whitlam Orthopaedic Research Centre, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia

⁷School of Public Health, University of Sydney, Sydney, Australia

⁸John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia

Abstract and keywords

Summary: This study examined hip fracture hospitalisation trends and predictors of access to rehabilitation for adults aged ≥ 65 years living with and without dementia. The hospitalisation rate was 2.5 times higher for adults living with dementia and adults who lived in aged care were between 4.8 and 9.3 times less likely to receive rehabilitation.

Introduction: To examine hip fracture hospitalisation temporal trends, health outcomes, and predictors of access to in-hospital rehabilitation for older adults living with and without dementia.

Methods: A population-based retrospective cohort study of adults aged ≥ 65 years hospitalised with a hip fracture during 2007–2017 in New South Wales, Australia.

Results: Of the 69,370 hip fracture hospitalisations, 27.1% were adults living with dementia. The hip fracture hospitalisation rate was 2.5 times higher for adults living with dementia compared with adults with no dementia (1186.6 vs 492.9 per 100,000 population). The rate declined by 6.1% per year (95%CI − 6.6 to − 5.5) for adults living with dementia and increased by 1.0% per year (95%CI 0.5–1.5) for adults with no dementia. Multivariable associations identified that adults living with dementia who experienced high frailty and increasing age were between 1.6 and 1.8 times less likely to receive in-hospital rehabilitation. Adults who were living in long-term aged care facilities were between 4.8 and 9.3 times less likely to receive in-hospital rehabilitation which varied by the presence of dementia or delirium.

Conclusion: Consistent criteria should be applied to determine rehabilitation access, and rehabilitation services designed for older adults living with dementia or in aged care are needed.

Keywords: Aged care; Dementia; Frailty; Hip fracture; Rehabilitation

Links

DOI: 10.1007/s00198-019-05260-8

PubMed: 31897545

WoS: 000505342800002

History

Received: 2019-10-02

Accepted: 2019-12-05

Online: 2020-01-02

Cited Works (2)

Year	Entry
2011	Cooper C, Cole ZA, Holroyd CR, Earl SC, Harvey NC, Dennison EM, Melton LJ, Cummings SR, Kanis JA; IOF CSA Working Group on Fracture Epidemiology. Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int. May 2011;22(5):1277-1288.
1997	Gullberg B, Johnell O, Kanis JA. World-wide projections for hip fracture. Osteoporos Int. September 1997;7(5):407-413.