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.

Highlights

• Adults living with dementia were able to make functional gains following hip fracture rehabilitation.

• Need to determine consistent criteria to determine access to hip fracture rehabilitation.

• Rehabilitation services specifically designed for adults living with dementia or in aged care are needed.

概要

这项研究调查了65岁以上有或没有痴呆症的成年人的髋部骨折住院治疗趋势和获得康复的预测因素。患有痴呆症的成年人的住院率要高出2.5倍，而接受老年护理的成年人的康复率要低4.8至9.3倍。

介绍

检查髋关节骨折住院患者的时间趋势，健康结果以及患有和不患有痴呆的老年人的院内康复机会的预测因素。

方法

在澳大利亚新南威尔士州进行的一项基于人群的回顾性队列研究，研究对象为年龄在65岁以上且≥65岁的成年人因髋部骨折而住院的病例。

结果

在69,370例髋部骨折住院治疗中，有27.1％是患有痴呆症的成年人。患有痴呆症的成年人的髋部骨折住院率比没有痴呆症的成年人高出2.5倍（1186.6对492.9 / 10万人口）。对于患有痴呆症的成年人，发病率每年下降6.1％（95％CI-6.6至-5.5），对于没有痴呆症的成年人，发病率每年上升1.0％（95％CI 0.5-1.5）。多变量协会发现，患有高虚弱和年龄增长的痴呆症成年人接受院内康复的可能性要低1.6到1.8倍。住在长期老年护理设施中的成年人接受院内康复的可能性要低4.8至9.3倍，因痴呆或or妄的存在而有所不同。

结论

应该采用一致的标准来确定康复机会，并且需要为患有痴呆症或老年护理的老年人设计的康复服务。

强调

•患有痴呆症的成年人在髋部骨折康复后能够获得功能上的进步。

•需要确定一致的标准来确定髋部骨折康复的途径。

•需要专门为患有痴呆症或老年护理的成年人设计的康复服务。