Declining daily functioning as a prelude to a hip fracture in older persons-an individual patient data meta-analysis.
disability
function
hip fracture
older people
Journal
Age and ageing
ISSN: 1468-2834
Titre abrégé: Age Ageing
Pays: England
ID NLM: 0375655
Informations de publication
Date de publication:
06 01 2022
06 01 2022
Historique:
received:
27
04
2021
revised:
23
09
2021
entrez:
25
1
2022
pubmed:
26
1
2022
medline:
29
1
2022
Statut:
ppublish
Résumé
Daily functioning is known to decline after a hip fracture, but studies of self-reported functioning before the fracture suggest this decline begins before the fracture. Determine whether change in functioning in the year before a hip fracture in very old (80+) differs from change in those without a hip fracture. Two-stage individual patient data meta-analysis including data from the Towards Understanding Longitudinal International older People Studies (TULIPS)-consortium. Four population-based longitudinal cohorts from the Netherlands, New Zealand and the UK. Participants aged 80+ years. Participants were followed for 5 years, during which (instrumental) activities of daily living [(I)ADL] scores and incident hip fractures were registered at regular intervals. Z-scores of the last (I)ADL score and the change in (I)ADL in the year before a hip fracture were compared to the scores of controls, adjusted for age and sex. Of the 2,357 participants at baseline, the 161 who sustained a hip fracture during follow-up had a worse (I)ADL score before the fracture (0.40 standard deviations, 95% CI 0.19 to 0.61, P = 0.0002) and a larger decline in (I)ADL in the year before fracture (-0.11 standard deviations, 95% CI -0.22 to 0.004, P = 0.06) compared to those who did not sustain a hip fracture. In the very old a decline in daily functioning already starts before a hip fracture. Therefore, a hip fracture is a sign of ongoing decline and what full recovery is should be seen in light of the pre-fracture decline.
Sections du résumé
BACKGROUND
Daily functioning is known to decline after a hip fracture, but studies of self-reported functioning before the fracture suggest this decline begins before the fracture.
OBJECTIVE
Determine whether change in functioning in the year before a hip fracture in very old (80+) differs from change in those without a hip fracture.
DESIGN
Two-stage individual patient data meta-analysis including data from the Towards Understanding Longitudinal International older People Studies (TULIPS)-consortium.
SETTING
Four population-based longitudinal cohorts from the Netherlands, New Zealand and the UK.
SUBJECTS
Participants aged 80+ years.
METHODS
Participants were followed for 5 years, during which (instrumental) activities of daily living [(I)ADL] scores and incident hip fractures were registered at regular intervals. Z-scores of the last (I)ADL score and the change in (I)ADL in the year before a hip fracture were compared to the scores of controls, adjusted for age and sex.
RESULTS
Of the 2,357 participants at baseline, the 161 who sustained a hip fracture during follow-up had a worse (I)ADL score before the fracture (0.40 standard deviations, 95% CI 0.19 to 0.61, P = 0.0002) and a larger decline in (I)ADL in the year before fracture (-0.11 standard deviations, 95% CI -0.22 to 0.004, P = 0.06) compared to those who did not sustain a hip fracture.
CONCLUSIONS
In the very old a decline in daily functioning already starts before a hip fracture. Therefore, a hip fracture is a sign of ongoing decline and what full recovery is should be seen in light of the pre-fracture decline.
Identifiants
pubmed: 35077559
pii: 6514236
doi: 10.1093/ageing/afab253
pmc: PMC8789300
pii:
doi:
Types de publication
Journal Article
Meta-Analysis
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of the British Geriatrics Society.
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