Functional Outcome of Elderly Hip Fracture Patients Is Not Affected by Prefracture Dementia

Objective The aim of the study was to examine whether a diagnosis of prefracture dementia (PFD) affects functional outcome at discharge from a geriatric rehabilitation setting. Design A total of 211 consecutive elderly hip fracture patients were evaluated retrospectively. We used the Functional Independence Measure (FIM) and analyzed data by t test, χ² test, and multiple linear regression analysis. Results Patients with PFD were older (P = 0.001), presented with lower Mini-Mental State Examination scores (P < 0.001) and lower prefracture function (P < 0.001). Total-FIM and motor-FIM scores at admission and discharge, as well as FIM gain scores at discharge, were lower among patients with PFD, compared with nonprefracture dementia (NPFD) patients (P < 0.001). The FIM daily gains (efficiency) (P < 0.001) and Montebello relative functional scores (P < 0.001) were also lower in PFD, compared with patients with NPFD. However, linear regression analysis showed that PFD did not predict total, motor, or FIM gain at discharge (β = -0.11, P = 0.115; β = -0.06, P = 0.412; β = -0.099, P = 0.329, respectively). Upon discharge, patients with PFD achieved lower FIM scores yet maintained similar motor-FIM gains compared with patients with NPFD. Conclusions Our study results supports the inclusion of patients with PFD in postfracture rehabilitation programs.