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The Pronounced Impact of Hip Fractures on Psychosocial Well-being
Jay Swayambunathan1, Abhijit Dasgupta, Timothy Bhattacharyya
1From the Clinical Trials and Outcomes Branch, National Institute for Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, MD.
Background:
There are little data on the psychosocial well-being of hip fracture patients. Previous studies lacked a control group to isolate the impact of hip fractures from general aging. We sought to overcome these limitations and quantify the impact of hip fractures on psychosocial well-being.
Methods:
We identified a cohort 65 years and older patients who were driving and mobile from the National Health and Aging Trends Study. Participants with exactly one hip fracture between 2011 and 2017 were isolated, and their outcomes an after hip fracture were compared with control subjects via multivariate logistic regression.
Results:
Hip fracture patients reported a notable decrease in driving frequency and mobility in the first year after fracture, along with an increase in depressive symptomatology and decreased participation in activities. Measures of mobility and activities among survivors returned to peer group levels within 2 years. A larger social network was associated with improved outcomes.
Discussion:
Hip fracture survivors experience notable declines in function and well-being in the first year after a hip fracture compared with peers. Although mortality is high, surviving patients experience measurable gains in function and well-being in the 3 years after the fracture. These data aid surgeons in counseling families and patients after hip fracture.
Level Of Evidence:
Level I-prognostic study: inception cohort study.
Study Design:
Prospective-patients enrolled at a uniform point in course of disease and followed over time.
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