The Impact of Cognitive Impairment on Rehabilitation Outcomes in Elderly Patients Admitted with a Femoral Neck Fracture
- 1 January 2009
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Geriatric Physical Therapy
- Vol. 32 (1), 24-32
- https://doi.org/10.1519/00139143-200932010-00006
Abstract
To evaluate the evidence of rehabilitation outcomes after the surgical repair of a hip fracture in older people with cognitive impairment. Systematic review. Searches were conducted in MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Library (Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effectiveness, and Cochrane Controlled Trials Register), ProQuest Dissertations, and Theses Database and bibliographies of extracted publications in the English language between 1990 and June 2007. Search terms included: dementia/Alzheimer disease/cognitive impairment, hip fracture, rehabilitation, outcome assessment/treatment outcome. Two independent reviewers undertook screening and methodological quality assessment, using the Downs and Black rating scale, of the extracted articles. Only studies evaluating rehabilitation outcomes with data analysis specific for cognitive status were evaluated. Sackett's levels of evidence were used to summarize the main findings. Eleven studies met the inclusion criteria. Methodological quality of the studies ranged from fair to poor. The generalizability of study findings was limited by multiple rehabilitation settings in the acute and subacute phase postsurgery, multiple methods with varying thresholds for determining cognitive impairment and multiple functional outcome scales. There is some evidence that older adults with cognitive impairment who receive intensive inpatient rehabilitation after surgical repair of a hip fracture may be able to gain comparable benefit in physical function as cognitively intact patients. There is not enough information to guide recommendations of specific physical therapy interventions to optimize outcomes in this patient population. Further work is needed.Keywords
This publication has 46 references indexed in Scilit:
- Economic Implications of Hip Fracture: Health Service Use, Institutional Care and Cost in CanadaOsteoporosis International, 2001
- The Economic Cost of Hip Fractures Among Elderly WomenPublished by Ovid Technologies (Wolters Kluwer Health) ,2001
- World-wide Projections for Hip FractureOsteoporosis International, 1997
- The Economic Cost of Hip Fractures in Community‐Dwelling Older Adults: A Prospective StudyJournal of the American Geriatrics Society, 1997
- Cohort study of risk of institutionalisation after hip fractureAustralian and New Zealand Journal of Public Health, 1996
- Risk Factors for Serious Injury During Falls by Older Persons in the CommunityJournal of the American Geriatrics Society, 1995
- The Contribution of Predisposing and Situational Risk Factors to Serious Fall InjuriesJournal of the American Geriatrics Society, 1995
- Hip fractures in the elderly: A world-wide projectionOsteoporosis International, 1992
- Incidence of hip fractures in the elderly: A cross-national analysisOsteoporosis International, 1991
- Risk Factors for Injurious Falls: a Prospective StudyJournal of Gerontology, 1991