09 Feb Hip Fractures Increase Mortality Risk in Cognitively Impaired Men
MedicalResearch.com Interview with:
Ann L. Gruber-Baldini, Ph.D.
Professor, Division of Gerontology
Director, Program in Epidemiology and Human Genetics
Department of Epidemiology & Public Health
University of Maryland School of Medicine
MedicalResearch.com: What is the background for this study?
Response: While men make up only about 25% of all hip fractures, the number of men who fracture their hip is increasing and we know men are more likely to die than women after a hip fracture. It is also known that those with cognitive impairments, typically due to delirium and Alzheimer’s disease and related dementia, are more likely to do more poorly after the fracture. The impact of both sex and cognition on outcomes after hip fracture has not been fully explored.
MedicalResearch.com: What are the main findings?
Response: Men have poorer cognition after hip fracture than women. This study shows that as many as 32% of men with cognitive impairment are likely to die within six months of a hip fracture compared with 11% of unimpaired men, 15% of cognitively impaired women, and only 2% of unimpaired women.
MedicalResearch.com: What should readers take away from your report?
Response: These findings suggest that men who are cognitively impaired are particularly vulnerable and in need of special attention to improve their likelihood of surviving. It may be valuable for clinicians to monitor hip fracture patients after hospital discharge (especially men) to see if they are still experiencing cognitive impairment and effects of delirium. Interventions to reduce delirium (evaluation of medications, nutrition, infections, and comorbidities) may be needed. It is also important that those with cognitive impairment get rehabilitation to help improve their mobility.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future research should look more into why men are more vulnerable to cognitive impairment and death after hip fracture and to whether there are more targeted interventions for men with cognitive impairment to improve survival.
MedicalResearch.com: Is there anything else you would like to add?
Study Strengths: Our sample had equal numbers of men and women so better able to examine the sex differences. We also had multiple measures of cognitive functioning. Measures were done around 15 days after admission, and so we have measures of people usually after their hospital discharge.
Study Weaknesses: There was limited information on delirium in the hospital. Our delirium diagnoses was based on the hospital chart, which is known to underdiagnose delirium, and so the cognitive impairment we measure may be a continuation of delirium that started in the hospital.
I have no disclosures.
This research was funded by grants from the National Institute on Aging at NIH.
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Gruber-Baldini AL, Hosseini M, Grattan L, Orwig D, Hochberg M, Chiles Shaffer N, Magaziner J. (2016, in press). Cognitive Differences between Men and Women who Fracture their Hip and Impact on Six-Month Survival. J Am Geriatr Soc. NIHMSID 813464
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