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A multidisciplinary intervention program improved the outcome after hip fracture for people with dementia--subgroup analyses of a randomized controlled trial.

Abstract：

BACKGROUND:People with cognitive impairment and dementia have a poor outcome after a hip fracture surgery, about 30-50% of all those who sustain a hip fracture have dementia. Therefore the aim was to investigate whether a multidisciplinary postoperative intervention program could reduce postoperative complications and improve functional recovery among people with dementia. METHODS:A randomized controlled trial with subgroup analyses among patients with dementia. Sixty-four patients with femoral neck fracture, aged ≥70 years at Umeå University Hospital, Sweden. The intervention consisted of staff education, individualized care planning and rehabilitation, active prevention, detection and treatment of postoperative complications, especially delirium. The staff worked in teams to apply comprehensive geriatric assessment, management and rehabilitation, including a follow-up at 4 months postoperatively. The control group followed conventional postoperative routines. RESULTS:There were fewer postoperative complications in the intervention group such as urinary tract infections, p=0.001; nutritional problems, p=0.025; postoperative delirium, p=0.002; falls, p=0.006. At 4 months a larger proportion in the intervention group had regained their previous independent indoor walking ability performance, p=0.005. At 12 months a larger proportion in the intervention group had regained the activities of daily living (ADL) performance level they had before the fracture, p=0.027. CONCLUSION:This study demonstrates that patients with dementia who suffer a hip fracture can benefit from multidisciplinary geriatric assessment and rehabilitation and should not be excluded from rehabilitation programs.

journal_name

Arch Gerontol Geriatr

journal_title

Archives of gerontology and geriatrics

authors

Stenvall M,Berggren M,Lundström M,Gustafson Y,Olofsson B

doi

10.1016/j.archger.2011.08.013

subject

Has Abstract

pub_date

2012-05-01 00:00:00

pages

e284-9

issue

eissn

0167-4943

issn

1872-6976

pii

S0167-4943(11)00259-7

journal_volume

pub_type

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A multidisciplinary intervention program improved the outcome after hip fracture for people with dementia--subgroup analyses of a randomized controlled trial.