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Mental Impairment as a Risk Indicator for Underweight and Aggravated Rehabilitation After Hip Fracture in Elderly Women
Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
1999 (English)In: Journal of Nutritional & Environmental Medicine, ISSN 1359-0847, E-ISSN 1364-6907, Vol. 9, no 1, 55-61 p.Article in journal (Refereed) Published
Abstract [en]

The objective of this prospective study was to analyze the role of mental impairment on nutritional status and functional capacity after hip fracture. Fifty-seven women aged 75 years or older, acutely admitted to a university hospital with a hip fracture, were consecutively included. Nutritional status with anthropometry and body composition, functional condition and activities of daily living (ADL) were collected 4-6 days and 3 months after surgery. Both lucid and mentally impaired women deteriorated in nutritional status in the postoperative period owing to loss of fat and muscle mass. In the mentally impaired group there was a 50% greater loss of body weight (not significant), causing underweight, mean body mass index 19.5 +/- 3.0 kg m-2, whereas body mass index remained normal in the lucid group, 21.3 +/- 3.0 kg m-2. Ability for activity, mobility and continence deteriorated significantly, whereas food and fluid intake remained unchanged in the mentally impaired group. Mental impairment is a major risk indicator for loss of functional capacities after an acute hip fracture. The development of malnutrition and underweight is explained by the lower pre-fracture body weight, giving little margin for the further post-fracture weight loss in this group. Actions to preserve preoperative ability regarding activity, mobility and continence among mentally impaired women seem warranted. A special caring programme directed towards the special needs of this high-risk group might increase their well-being and ability to continue living in their own homes.

Place, publisher, year, edition, pages
1999. Vol. 9, no 1, 55-61 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-26795DOI: 10.1080/13590849961843Local ID: 11400OAI: oai:DiVA.org:liu-26795DiVA: diva2:247345
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Nutritional status and functional capacity in elderly people with hip fracture
Open this publication in new window or tab >>Nutritional status and functional capacity in elderly people with hip fracture
2000 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim was to study nutritional status and functional capacity in elderly men and women admitted to hospital with a hip fractnre, and to evaluate the effect of nutritional intervention and surgical method. A total of 176 patients participated in the study. Of them 84 received protein- and energy-enriched meals at hospital and nutritional advice on discharge and at home. A total of 100 patients with displaced femoral neck fracture were randomised to treatment with either total hip arthroplasty or osteosynthesis with Olmed® screws.

The patients were examined and interviewed the first time within 4-6 days after surgery, as well as one and three months aud one year after surgery. The nutritional status was assessed with body mass index, measures of triceps skinfold thickness, estimation of muscle mass and body composition. Serum albumin, insulin-like growth factor-I and hormones were measured. Functional capacity was assessed with the Modified Norton scale, Katz index of ADL and a questionnaire measuring instrumental activities of daily living.

Mentally impaired patients had worse nutritional status aud functional condition compared with the lucid group at inclusion, deteriorated more in activity and mobility fimctions and had a higher one-year mortality rate. The nutritional intervention was not powerful enough to have effect on anthropometric or biochemical measurements. The patients treated with total hip arthroplasty had reduced pain, better locomotion ability and a slight weight gain compared with the osteosynthesis group.

In conclusion, a marked deterioration of nutritional and functional status was found after a hip fracture. Studies of the effect of a more powerful nutritional intervention on nutritional status and functional capacity in this group are warranted. Patients treated with total hip arthroplasty had a more favourable rehabilitation period with regard to nutritional status and locomotion ability.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2000. 61 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 649
Keyword
elderly people, functional capacity, hip fractnre, mental impairment, nutritional status
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-27458 (URN)12111 (Local ID)91-7219-750-1 (ISBN)12111 (Archive number)12111 (OAI)
Public defence
2000-11-18, Berzeliussalen, Universitetssjukhuset, Linköping, 09:00 (Swedish)
Opponent
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-08-15Bibliographically approved

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Bachrach-Lindström, MargarethaUnosson, Mitra

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