Factors Associated with Recovered Functionality After Hip Fracture in Non-Institutionalized Older Adults: A Case-Control Study Nested in a Cohort

Purpose: To identify factors associated with recovered functionality after a hip fracture in a sample of older adult patients. Patients and Methods: Nested case-control study in a cohort. Older adults (60 years or older) with a hip fracture were recruited between May 2017 and October 2018. The Barthel scale was used to measure performance in activities of daily living (ADL). A questionnaire was applied to collect information about demographic, clinic, psychological and social variables, and anthropometric measurements were taken. A logistic regression model was built to analyze various factors related to recovered functionality. Results: A total of 346 older adults with a hip fracture were studied (n=173 cases and n=173 controls); 69.4% (n=240) women and 30.6% (n=140) men. Mean age was 79.4 years (+/- 8.7) overall; for cases, 77.4 (+/- 7.9) years and for controls, 81.4 (+/- 9.0). Mean schooling was 6.3 (+/- 4.3) years. Recovered functionality was associated with normal nutritional status (OR 4.81, 95% CI = 2.54- 9.12), absence of heart disease (OR 4.08, 95% CI = 1.48- 11.20), self-efficacy for ADL (OR 4.07, 95% CI = 2.15- 7.72), absence of depressive symptoms (OR 2.99, 95% CI = 1.69- 5.28), prior functionality (OR 2.83, 95% CI = 1.51- 5.31), high socioeconomic level (OR 2.41, 95% CI = 1.24- 4.65) and transcervical fracture (OR 2.34, 95% CI = 1.05-5.22). Conclusion: In older adults who have suffered a hip fracture, clinical, psychological, and demographic characteristics are associated with recovered functionality. These factors should be considered as a priority in the care of older adults who have experienced hip fractures.