[Fractures from falls in elderly patients: are they neuropsychiatric emergencies?]

To identify a possible link between mental impairment and spontaneous fall-related fractures, we studied two groups of elderly hospitalized patients for physical and cognitive status. The study population consisted of 120 patients admitted for post-surgical rehabilitation after fall-related fractures (FRF). The patients were living at home when the accident occurred. The mean age was 81.0 years; 110 women, mean age 81.2 +/- 8.1; 10 men, mean age 82.8 +/- 8.5 years). The control group consisted of 81 patients hospitalized for somatic conditions who had never had falls or fractures (46 women and 35 men, mean age 79.4 +/- 5.7 years). The following cognitive tests were used: Folstein's MMSE, Benton's visual recall, and the Rey figure with both subtests (copy: RC; and recall: RM). In the study population (95%) 114 patients had previously fallen and 44 (38%) had had fractures, 65% had cardiovascular disease, compared to 6% of the controls. The respective mean psychometric scores for each test in the study and control population were as follows: MMSE: 18.92 +/- 6.45 vs 24.2 +/- 3.2 (normal value > 25); P = 4.5 x 10(-8). Benton: 11.03 +/- 4.91 vs 15.69 +/- 3.2 (normal value > 25); P = 2.3 x 10(-8). RC: 14.84 +/- 9.9 vs 25 +/- 7.6 (normal value > 30); P = 4.5 x 10(-8). RM: 4.55 +/- 4.5 vs 9.04 +/- 5.7 (normal value > 22); P = 2.17 x 10(-8). Despite these patient's apparently normal social facade, they had a far mode marked and significated mental deterioration than the controls.(ABSTRACT TRUNCATED AT 250 WORDS)