Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep;27(3):220-227.
doi: 10.4235/agmr.23.0040. Epub 2023 Aug 28.

Factors Associated with Improvement in Activities of Daily Living during Hospitalization: A Retrospective Study of Older Patients with Hip Fractures

Kazuya Takeda  1   2 , Mineko Wada  2 , Kyosuke Yorozuya  3 , Yuhei Hara  4 , Toyoaki Watanabe  5 , Hideaki Hanaoka  2
Affiliations

Factors Associated with Improvement in Activities of Daily Living during Hospitalization: A Retrospective Study of Older Patients with Hip Fractures

Kazuya Takeda et al. Ann Geriatr Med Res. 2023 Sep.

Abstract

Background: In this study, we aimed to examine the changes in delirium during hospitalization of patients and its association with behavioral and psychological symptoms of dementia (BPSD), as well as improvements in activities of daily living (ADL).

Methods: A longitudinal, retrospective cohort study was conducted involving 83 older adults (≥65 years) with hip fractures. We collected Mini-Mental State Examination (MMSE) and Functional Independence Measure-motor domain (m-FIM) assessment results from the medical charts at two time points: baseline (first week of hospitalization) and pre-discharge (final week before discharge). Additionally, we collected data on delirium and BPSD at three points: baseline, week 2 post-admission, and pre-discharge. We performed univariate logistic regression analysis using changes in m-FIM scores as the dependent variable and MMSE and m-FIM scores at baseline and pre-discharge, along with delirium and BPSD subtypes at baseline, week 2 post-admission, and pre-discharge, as the explanatory variables. Finally, we performed a multivariate logistic regression analysis incorporating the significant variables from the univariate analysis to identify factors associated with ADL improvement during hospitalization.

Results: We observed significant correlations between ADL improvement during hospitalization and baseline m-FIM and MMSE scores, hypoactive delirium state, and BPSD subtype pre-discharge. Notably, all participants with hypoactive symptoms before discharge exhibited some subtype of delirium and BPSD at baseline.

Conclusion: Besides ADL ability and cognitive function at admission, the presence of hypoactive delirium and BPSD subtype before discharge may hinder ADL improvement during hospitalization.

Keywords: Activities of daily living; Apathy; Behavioral symptoms; Delirium; Dementia; Hip fractures.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST

The researchers claim no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Study enrollment summary. MMSE, Mini-Mental State Examination.
Fig. 2.
Fig. 2.
The changes in the subtypes of the 16 pre-discharge hypoactive participants at baseline and week 2 post-admission. BPSD, behavioral and psychological symptoms of dementia.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Dhanwal DK, Dennison EM, Harvey NC, Cooper C. Epidemiology of hip fracture: worldwide geographic variation. Indian J Orthop. 2011;45:15–22. - PMC - PubMed
    1. Orimo H, Yaegashi Y, Hosoi T, Fukushima Y, Onoda T, Hashimoto T, et al. Hip fracture incidence in Japan: Estimates of new patients in 2012 and 25-year trends. Osteoporos Int. 2016;27:1777–84. - PMC - PubMed
    1. Fernandez MA, Griffin XL, Costa ML. Management of hip fracture. Br Med Bull. 2015;115:165–72. - PubMed
    1. Friedman SM, Menzies IB, Bukata SV, Mendelson DA, Kates SL. Dementia and hip fractures: development of a pathogenic framework for understanding and studying risk. Geriatr Orthop Surg Rehabil. 2010;1:52–62. - PMC - PubMed
    1. Abeygunasekara T, Lekamwasam S, Lenora J, Alwis G. Quality of life and functional independence of hip fracture patients: data from a single center follow-up study in Sri Lanka. Ann Geriatr Med Res. 2021;25:98–104. - PMC - PubMed

LinkOut - more resources