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Frail hip fracture patients 'more likely to experience worse outcomes'

20:00 EDT 6 Aug 2015 | Arthritis Research UK

Older people who suffer from physical frailty are more likely to experience pain and declining physical function if they then sustain a hip fracture.

This is according to a new study led by Spain's Galdakao-Usansolo Hospital, which aimed to identify predictors of pain and declines in function among elderly patients following a fall-related hip fracture.

A group of 740 patients aged 65 or older who fractured their hip in a fall were asked to retrospectively complete pre-fracture status questionnaires and were then prospectively followed for six months. Of these, 474 were randomly selected to complete an additional 18 months of follow-up.

Primary outcome measures were changes in pain and functional outcomes, with sociodemographic variables, in-hospital and clinical pre- and post-fracture data, and activities of daily living at baseline and follow-up all assessed as potential predictors.

According to results published in the journal Osteoporosis International, predictors of worsening pain included living in a home care situation or nursing home before the fracture, or low pre-fracture pain levels.

Predictors of deterioration in function, meanwhile, included being age 85 years or older, lower income, high pre-fracture hip function, referral to rehabilitation upon discharge, and a longer delay between fall and surgery.

The researchers concluded: "Frailty before hip fracture is a predictor of greater post-fracture pain and deterioration in function. Given that exercise programmes help prevent frailty, promoting exercise in elderly may improve the prognosis of hip fracture."

It was noted that addressing some of these variables would improve the prognosis of those with hip fractures, making this an important issue for societies dealing with ageing populations such as the UK.

A spokeswoman for Arthritis Research UK, which funds research into osteoporosis, commented: "Research is starting to show that inactivity could be as much of a cause of physical frailty as the actual ageing process.

"Keeping active is good for us, particularly as we age. However, few older people do much exercise, and we need to find more effective ways of encouraging them to keep moving."

Original Article: Frail hip fracture patients 'more likely to experience worse outcomes'

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