A 2-Minute Cognitive Screener for Predicting 1-Year Functional Recovery and Survival in Older Adults After Hip Fracture Repair

Imagem de Miniatura
Arquivos
art_FORTES-FILHO_A_2Minute_Cognitive_Screener_for_Predicting_1Year_Functional_2022.PDF (570.76 KB)
Citações na Scopus
5
Tipo de produção
article
Data de publicação
2022
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
OXFORD UNIV PRESS INC
Autores
Citação
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES, v.77, n.1, p.172-179, 2022
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: Implementing cognitive assessment in older people admitted to hospital with hip fracture-lying in bed, experiencing pain-is challenging. We investigated the value of a quick and easy-to-administer 10-point Cognitive Screener (10-CS) in predicting 1-year functional recovery and survival after hip surgery. Methods: Prospective cohort study comprising 304 older patients (mean age = 80.3 +/- 9.1 years; women = 72%) with hip fracture consecutively admitted to a specialized academic medical center that supports secondary hospitals in Sao Paulo Metropolitan Area, Brazil. The 10-CS, a 2-minute bedside tool including temporal orientation, verbal fluency, and three-word recall, classified patients as having normal cognition, possible cognitive impairment, or probable cognitive impairment on admission. Outcomes were time-torecovery activities of daily living (ADLs; Katz index) and mobility (New Mobility Score), and survival during 1-year after hip surgery. Hazard models, considering death as a competing risk, were used to associate the 10-CS categories with outcomes after adjusting for sociodemographic and clinical measures. Results: On admission, 144 (47%) patients had probable cognitive impairment. Compared to those cognitively normal, patients with probable cognitive impairment presented less postsurgical recovery of ADLs (77% vs 40%; adjusted sub-hazard ratio [HR] = 0.44; 95% confidence interval (CI] = 0.32-0.62) and mobility (50% vs 30%; adjusted sub-HR = 0.52; 95% CI = 0.34-0.79), and higher risk of death (15% vs 40%; adjusted HR = 2.08; 95% CI = 1.03-4.20) over 1-year follow-up. Conclusions: The 10-CS is a strong predictor of functional recovery and survival after hip fracture repair. Cognitive assessment using quick and easy-to-administer screening tools like 10-CS can help clinicians make better decisions and offer tailored care for older patients admitted with hip fracture.
Palavras-chave
Cognitive impairment, Competing risk, Hip fracture, Prognosis, Screening
URI
https://observatorio.fm.usp.br/handle/OPI/44636
Referências
  1. Aliberti MJR, 2021, J GERONTOL A-BIOL, V76, P1134, DOI 10.1093/gerona/glaa303
  2. Aliberti MJR, 2020, CLIN NUTR, V39, P2114, DOI 10.1016/j.clnu.2019.08.026
  3. Aliberti MJR, 2019, J GERONTOL A-BIOL, V74, P1637, DOI 10.1093/gerona/glz109
  4. Apolinario D, 2016, INT J GERIATR PSYCH, V31, P4, DOI 10.1002/gps.4282
  5. Baker NL, 2011, AGE AGEING, V40, P49, DOI 10.1093/ageing/afq146
  6. Beveridge M, 2004, J BONE JOINT SURG AM, V86A, P1819, DOI 10.2106/00004623-200408000-00029
  7. Borson S, 2003, J AM GERIATR SOC, V51, P1451, DOI 10.1046/j.1532-5415.2003.51465.x
  8. Brodaty H, 2002, J AM GERIATR SOC, V50, P530, DOI 10.1046/j.1532-5415.2002.50122.x
  9. CHARLSON ME, 1987, J CHRON DIS, V40, P373, DOI 10.1016/0021-9681(87)90171-8
  10. Daabiss M, 2011, INDIAN J ANAESTH, V55, P111, DOI 10.4103/0019-5049.79879
  11. Daniels Alan H, 2014, Am J Orthop (Belle Mead NJ), V43, pE146
  12. DELONG ER, 1988, BIOMETRICS, V44, P837, DOI 10.2307/2531595
  13. FOLSTEIN MF, 1983, ARCH GEN PSYCHIAT, V40, P812
  14. Fortes SQ, 2016, AGE AGEING, V45, P711, DOI 10.1093/ageing/afw084
  15. Hill AM, 2021, J GERONTOL A-BIOL, V76, P1814, DOI 10.1093/gerona/glaa283
  16. HODKINSON H M, 1972, Age and Ageing, V1, P233, DOI 10.1093/ageing/1.4.233
  17. INOUYE SK, 1990, ANN INTERN MED, V113, P941, DOI 10.7326/0003-4819-113-12-941
  18. Jones CA, 2017, J GERONTOL A-BIOL, V72, P61, DOI 10.1093/gerona/glv138
  19. Kata A, 2020, J GEN INTERN MED, V35, P1946, DOI 10.1007/s11606-020-05644-1
  20. KATZ S, 1963, JAMA-J AM MED ASSOC, V185, P914, DOI 10.1001/jama.1963.03060120024016
  21. Kotwal AA, 2020, J AM GERIATR SOC, V68, P1796, DOI 10.1111/jgs.16451
  22. Lavikainen P, 2020, J GERONTOL A-BIOL, V75, P2184, DOI 10.1093/gerona/glaa199
  23. Lee TH, 1999, CIRCULATION, V100, P1043, DOI 10.1161/01.CIR.100.10.1043
  24. Mitchell R, 2017, ARCH GERONTOL GERIAT, V72, P135, DOI 10.1016/j.archger.2017.06.006
  25. Mizrahi EH, 2018, ARCH GERONTOL GERIAT, V78, P177, DOI 10.1016/j.archger.2018.06.016
  26. Mukka Sebastian, 2017, Eur J Orthop Surg Traumatol, V27, P653, DOI 10.1007/s00590-016-1873-9
  27. Nardi M, 2018, J AM MED DIR ASSOC, V19, P122, DOI 10.1016/j.jamda.2017.08.009
  28. Nasreddine ZS, 2005, J AM GERIATR SOC, V53, P695, DOI 10.1111/j.1532-5415.2005.53221.x
  29. National Institute for Health and Care Excellence, 2018, NAT I HLTH CAR EXC C
  30. Neerland BE, 2017, PLOS ONE, V12, DOI 10.1371/journal.pone.0180641
  31. Ouellet JA, 2019, J AM GERIATR SOC, V67, P1386, DOI 10.1111/jgs.15870
  32. PARKER MJ, 1993, J BONE JOINT SURG BR, V75, P797, DOI 10.1302/0301-620X.75B5.8376443
  33. Pencina MJ, 2012, STAT MED, V31, P101, DOI 10.1002/sim.4348
  34. Savino E, 2013, AM J MED, V126, P1068, DOI 10.1016/j.amjmed.2013.04.017
  35. Smith T, 2014, AGE AGEING, V43, P464, DOI 10.1093/ageing/afu065
  36. Soderqvist A, 2006, J BONE JOINT SURG AM, V88A, P2115, DOI 10.2106/JBJS.E.01409
  37. Stenvall M, 2012, ARCH GERONTOL GERIAT, V54, pE284, DOI 10.1016/j.archger.2011.08.013
  38. Stolz E, 2021, J GERONTOL A-BIOL, V76, P1260, DOI 10.1093/gerona/glaa234
  39. Tang VL, 2017, J GEN INTERN MED, V32, P153, DOI 10.1007/s11606-016-3848-2
  40. Yiannopoulou KG, 2012, HIP INT, V22, P209, DOI 10.5301/HIP.2012.9229

Coleções
Artigos e Materiais de Revistas Científicas - FM/Outros
Artigos e Materiais de Revistas Científicas - FM/MOT
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/IOT
Artigos e Materiais de Revistas Científicas - LIM/41
Artigos e Materiais de Revistas Científicas - LIM/66