Mental Impairment as a Risk Indicator for Underweight and Aggravated Rehabilitation After Hip Fracture in Elderly Women

Abstract

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.