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Hip fracture and the influence of dementia on health outcomes and access to hospital-based rehabilitation for older individuals
Open accessAbstract
BACKGROUND: For older individuals who sustain a hip fracture, the presence of dementia can influence their access to hospital-based rehabilitation. PURPOSE: This study compares the characteristics and health outcomes of individuals with and without dementia following a hip fracture; and access to, and outcomes following, hospital-based rehabilitation in a population-based cohort. METHOD: An examination of hip fractures involving individuals aged 65 years and older with and without dementia using linked hospitalisation, rehabilitation and mortality records during 2009-2013. RESULTS: There were 8785 individuals with and 23 520 individuals without dementia who sustained a hip fracture. Individuals with dementia had a higher age-adjusted 30-d mortality rate compared to individuals without dementia (11.7% versus 5.7%), a lower proportion of age-adjusted 28-d re-admission (17.3% versus 24.4%) and a longer age-adjusted mean length of stay (22.2 versus 21.9 d). Compared to individuals without dementia, individuals with dementia had 4.3 times (95% CI: 3.90-4.78) lower odds of receiving hospital-based rehabilitation. However, when they did receive rehabilitation they achieved significant motor functional gain at discharge compared to admission using the Functional Independence Measure, but to a lesser extent than individuals without dementia. CONCLUSION: Within a population-based cohort, older individuals with dementia can benefit from access to, and participation in, rehabilitation activities following a hip fracture. This will ensure that they have the best chance of returning to their pre-fracture physical function and mobility. Implications for Rehabilitation Older individuals with dementia can benefit from rehabilitation activities following a hip fracture. Early mobilisation of individuals post-hip fracture surgery, where possible, is advised. Further work is needed on how best to work with individuals with dementia after a hip fracture in residential aged care to maximise any potential functional gains.
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Reduced referrals limited access to supportive services despite evidence of potential benefits.
“When HCPs assumed patients with MLTCiD were unable to participate in rehabilitation or educational programmes, referrals were reduced, which limited access to supportive services despite evidence of potential benefits (CMOC12) [49, 53, 88, 89].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [88]
When healthcare professionals assumed patients with MLTCiD were unable to participate in rehabilitation or educational programmes, referrals were reduced.
“When HCPs assumed patients with MLTCiD were unable to participate in rehabilitation or educational programmes, referrals were reduced, which limited access to supportive services despite evidence of potential benefits (CMOC12) [49, 53, 88, 89].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [88]
Collaboration between healthcare professionals was associated with delayed discharges, emphasising the problem in care co-ordination.
“As a result, collaboration between HCPs was associated with delayed discharges, emphasising the problem in care co-ordination (CMOC19) [40, 42, 74, 83, 88, 91, 92].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [88]
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Metadata
- Authors
- Mitchell, R., Harvey, L., Brodaty, H., Draper, B., & Close, J.
- Affiliations
- UNSW Sydney (AU)
- Corresponding author
- Mitchell, Rebecca
- Venue
- Disability and Rehabilitation
- Publisher
- Informa UK Limited
- Published
- 2016-01-14
- Volume
- 38
- Issue
- 23
- Pages
- 2286-2295
- ISSN
- 0963-8288 (ISSN-L)
- 1464-5165
- OpenAlex
- W2273794073
- Cited by
- 72
- References
- 41
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 7 · 2023: 7 · 2022: 5 · 2021: 8 · 2020: 13 · 2019: 5 · 2018: 11 · 2017: 3 · 2016: 2
- FWCI
- 7.75
- Type
- journal article
- Language
- en
- Open access
- green
- handle.unsw.edu.au
- Licence
- cc-by-nc-nd
- Locations
- Disability and Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- UNSWorks (UNSW Sydney) (submittedVersion, cc-by-nc-nd)
- Funders
- NSW Ministry of Health
- Topics
- Health Sciences › Medicine › Surgery › Hip and Femur Fractures
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- hip fracture, dementia, hospital-based rehabilitation, older adults, postoperative mortality, hospital readmission, length of hospital stay, functional independence, motor recovery, early mobilization, nursing homes
- MeSH terms
- Aged, Aged, 80 and over, Dementia, Female, Hip Fractures, Hospitalization, Humans, Male, Middle Aged, New South Wales, Registries, Retrospective Studies, Logistic Models
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