Hip fracture in patients with Alzheimer's disease

Abstract

The purpose of this study was to evaluate the outcome of hip fracture repair and rehabilitation in patients with Alzheimer's disease.

A retrospective study of patients with Alzheimer's disease, who sustained hip fracture repair during the years 1992 and 1993 was done. All patients were living in the community and were followed in the Memory Disorder Institute (MDI) in a large community hospital. A total of nineteen patients with dementia had sustained a hipfracture and 14 patients met the criteria of probable Alzheimer's disease. Five patients were excluded due to non Alzheimer's type of dementia. Surgical hip repair was performed in 13 patients. One patient refused surgery. All patients had 10 days of rehabilitation for ambulation. Patients who needed longer rehabilitation were transferred to a rehabilitation center.

Post operative findings include the fact that all 14 patients were able to ambulate 25 feet with assistance in the rehabilitation department (including a patient who refused surgical repair). One month follow-up after hospital discharge reveals that patients with pre-hip fracture Mini-Mental Status (MMSE) equal or below 15 (total of 9 patients), were unable to ambulate with any assistance. There were four patients with MMSE > 15. Three were able to ambulate after hip surgical repair (with or without assistance), although one patient was non ambulatory. Interestingly, even the patient who refused surgical repair (MMSE = 10), was able to ambulate 50 feet with a walker while in the hospital After discharge to her home, she was unable to ambulate.

Our findings suggest that none of the patients with Alzheimer's disease and MMSE ≤ 15, who sustained hip fracture repair were able to ambulate one month after hospital discharge.