Gender differences and cognitive aspects on functional outcome after hip fracture--a 2 years' follow-up of 2,134 patients.

BACKGROUND

hip fractures as well as cognitive dysfunction become increasingly prevalent in growing ageing populations. Hip fractures are approximately three times more common in elderly women.

OBJECTIVE

we analysed outcome after hip fracture with respect to gender and cognitive function.

DESIGN

population-based, prospective cohort study.

SETTING

four university hospitals in Stockholm, Sweden.

SUBJECTS: a total of 2,134 consecutive patients admitted with hip fracture during 2003.

METHODS

gender differences in residence, walking ability and activity of daily living (ADL) were analysed at baseline, after 4 and 24 months in patients with and without intact cognitive function.

RESULTS

women were older, more often living alone and had poorer walking ability (P < 0.001). Cognitive dysfunction was equally common by gender. Women were more often treated with a prosthesis (P < 0.001) and sent to rehabilitation (P < 0.001). In the cognitive dysfunction group, men had more co-morbidity (P < 0.001) and total loss of walking ability (P = 0.03), but more often resided in own homes (P = 0.03). There was no gender difference in ADL.

CONCLUSION

men had a higher risk for loss of walking ability and death only in patients with cognitive dysfunction. Cognitive function was the most important factor for returning to own home and regain pre-fracture function.