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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #355406

Research Project: Nutrients, Aging, and Musculoskeletal Function

Location: Jean Mayer Human Nutrition Research Center On Aging

Title: Association between caregiver role and short- and long-term functional recovery after hip fracture: a prospective study

Author
item Nardi, Marlis - University Hospital Zurich
item Fischer, Karina - University Of Zurich
item Dawson-hughes, Bess - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item Orav, Endel - Harvard University
item Meyer, Otto - University Of Zurich
item Meyer, Ursina - University Of Zurich
item Beck, Sacha - University Hospital Zurich
item Simmen, Hans-peter - University Hospital Zurich
item Pape, Hans-christoph - University Hospital Zurich
item Egli, Andreas - University Of Zurich
item Willett, Walter - Harvard University
item Theiler, Robert - University Of Zurich
item Bischoff-ferrari, Heike - University Of Zurich

Submitted to: Journal of the American Medical Directors Association - Post-Acute and Long Term Care Medicine
Publication Type: Review Article
Publication Acceptance Date: 1/24/2018
Publication Date: 2/4/2018
Citation: Nardi, M., Fischer, K., Dawson-Hughes, B., Orav, E.J., Meyer, O.W., Meyer, U., Beck, S., Zimmen, H., Pape, H., Egli, A., Willett, W.C., Theiler, R.A., Bischoff-Ferrari, H.A. 2018. Association between caregiver role and short- and long-term functional recovery after hip fracture: a prospective study. Journal of the American Medical Directors Association - Post-Acute and Long Term Care Medicine. 19(2):122-129. http://dx.doi.org/10.1016/j.jamda.2017.08.009.
DOI: https://doi.org/10.1016/j.jamda.2017.08.009

Interpretive Summary:

Technical Abstract: Objectives: After a hip fracture, 50% of senior patients are left with permanent functional decline and 30% lose their autonomy. The aim of this prospective study was to evaluate whether seniors who are in a caregiver role have better functional recovery after hip fracture compared with noncaregivers. Design: Prospective observational study. Setting: A total of 107 Swiss patients with acute hip fracture age 65 years and older (84% women; 83.0 +/- 6.9 years; 87% community-dwelling). Measurements: At baseline, participants were asked if they were caregivers for a person, a pet, or a plant. Lower-extremity mobility was measured using the Timed Up and Go (TUG) test at baseline during acute care (day 1-12 after hip fracture surgery) and at 6 and 12 months follow-up. Subjective physical functioning (SPF) was rated for prefracture values and at 6 and 12 months follow-up using the Short Form 36 Health Survey questionnaire. Differences in TUG performance or SPF between caregivers and noncaregivers at 6 and 12 months were assessed using multivariable repeated-measures analysis adjusted for age, sex, body mass index, Charlson comorbidity index, Mini-Mental State Examination, living condition, baseline TUG, and treatment (vitamin D, home exercise program as part of the original trial). Results: At baseline, adjusted TUG performance was better in caregivers of any kind compared with noncaregivers (40.9 vs 84.4 seconds, P < .0001). At 6 months, and after adjustment for baseline TUG performance and other covariates, TUG was better in caregivers of any kind (-6.4 seconds, P = .007) and caregivers of plants (-6.6 seconds, P =.003) compared with noncaregivers. At 12 months, only caregivers of persons had better TUG performance compared with noncaregivers (-7.3 seconds, P = .009). Moreover, at 12 months, SPF was better in caregivers of persons (58.9 vs 45.6, P = .01) and caregivers of any kind (50.8 vs 39.3, P = .02) compared with noncaregivers. Conclusions: Senior hip fracture patients who have a caregiver role of any kind, and especially of plants, had better short-term recovery after hip fracture assessed with the TUG. For long-term recovery, senior hip fracture patients who are caregivers for other persons appeared to have a significant benefit. These benefits were independent of baseline function and all other covariates.