Many Older People with Hip Fracture Experience Disability Before Fracture

Summary: The incidence of hip fracture is a growing problem in the United States and globally as the population ages. Individuals with hip fractures are often frail and elderly and may have some level of disability beforehand. Hip fracture is generally treated as an acute injury, with a focus on preventing disability following the fracture. However, it’s possible that the fracture accelerates the person’s existing disability, which would suggest the need to change the focus of post-fracture care. To better understand the prevalence of disability (difficulty walking, climbing stairs, bathing, etc.) prior to hip fracture, scientists analyzed health data from the Health and Retirement Study (HRS) of 857 Americans age 65 and older who experienced hip fracture. The HRS collects information from adults age 50 and older every two years, allowing the researchers to examine the health of the hip fracture study population before and after injury. Two years prior to hip fracture, disability rates among this group were approximately 20 percent. However, starting about 10 months prior to hip fracture, disability rates increased 2.4 percent each month until they reached about 44 percent one month before hip fracture. The researchers suggest that the high rate of pre-hip-fracture disability indicates that post-fracture management should be re-evaluated to focus on the provision of palliative care to address symptom burden within the context of diminished functionality, increased disability, and greater dependence on supportive care.

Citation: Smith AK, Cenzer IS, Boscardin JW, et al. Increase in Disability Prevalence Before Hip Fracture. J Am Geriatr Soc. 2015 Oct; 63(10):2029–35. PMID: 26480970