Factors Associated with Recovered Functionality After Hip Fracture in Non-Institutionalized Older Adults: A Case-Control Study Nested in a Cohort

Eliseo Ramírez-García; Guadalupe S García de la Torre; Erika Judith Rodríguez Reyes; Karla Moreno-Tamayo; María Claudia Espinel-Bermudez; Sergio Sánchez-García

doi:10.2147/CIA.S320341

Factors Associated with Recovered Functionality After Hip Fracture in Non-Institutionalized Older Adults: A Case-Control Study Nested in a Cohort

Clin Interv Aging. 2021 Aug 17:16:1515-1525. doi: 10.2147/CIA.S320341. eCollection 2021.

Authors

Eliseo Ramírez-García¹, Guadalupe S García de la Torre², Erika Judith Rodríguez Reyes³, Karla Moreno-Tamayo¹, María Claudia Espinel-Bermudez⁴, Sergio Sánchez-García¹

Affiliations

¹ Epidemiological and Health Services Research Unit, Aging Area, National Medical Center XXI Century, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
² Public Health Department, School of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico.
³ Epidemiological Surveillance Coordination, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
⁴ Clinical Epidemiology Research Unit, UMAE Specialties Hospital, Western Medical Center, Instituto Mexicano del Seguro Social, Guadalajara, México.

Abstract

Purpose: To identify factors associated with recovered functionality after a hip fracture in a sample of older adult patients.

Patients and methods: Nested case-control study in a cohort. Older adults (60 years or older) with a hip fracture were recruited between May 2017 and October 2018. The Barthel scale was used to measure performance in activities of daily living (ADL). A questionnaire was applied to collect information about demographic, clinic, psychological and social variables, and anthropometric measurements were taken. A logistic regression model was built to analyze various factors related to recovered functionality.

Results: A total of 346 older adults with a hip fracture were studied (n=173 cases and n=173 controls); 69.4% (n=240) women and 30.6% (n=140) men. Mean age was 79.4 years (±8.7) overall; for cases, 77.4 (±7.9) years and for controls, 81.4 (±9.0). Mean schooling was 6.3 (± 4.3) years. Recovered functionality was associated with normal nutritional status (OR 4.81, 95% CI = 2.54-9.12), absence of heart disease (OR 4.08, 95% CI = 1.48-11.20), self-efficacy for ADL (OR 4.07, 95% CI = 2.15-7.72), absence of depressive symptoms (OR 2.99, 95% CI = 1.69-5.28), prior functionality (OR 2.83, 95% CI = 1.51-5.31), high socioeconomic level (OR 2.41, 95% CI = 1.24-4.65) and transcervical fracture (OR 2.34, 95% CI = 1.05-5.22).

Conclusion: In older adults who have suffered a hip fracture, clinical, psychological, and demographic characteristics are associated with recovered functionality. These factors should be considered as a priority in the care of older adults who have experienced hip fractures.

Keywords: case-control studies; functionality; hip fracture; older adults.

MeSH terms

Accidental Falls
Activities of Daily Living*
Aged
Case-Control Studies
Fear
Female
Hip Fractures* / epidemiology
Humans
Male
Recovery of Function

Grants and funding

This study was financed with grants from the Fund for the Development of Technological Research and Development Protocols on Priority Health Issues, IMSS (FIS/IMSS/PROT/PRIO/16/060). The findings and conclusions in this article are those of the authors and do not necessarily represent the views of funding agencies.