DISABLEMENT PROCESS OF HIP FRACTURE SURVIVORS

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The broad long-term objectives of this proposal are to understand the disablement process and health care utilization among community- dwelling elderly hip fracture subjects. The specific aims of this proposal are: (1) To examine longitudinal patterns of functional change among hip fracture survivors to determine change in physiological function (e.g., knee strength), functional limitation (e.g., walking speed), and functional disability (e.g., ADL) over time and rate of change between hip fracture and non-hip fracture study subjects, and long-term prognosis; (2) To examine the synergistic effects of age, depression, comorbidity, and social support on physiological function, functional limitation, and functional disability over time between hip fracture and nonhip fracture groups; (3) To examine factors associated with functional independence among hip fracture patients; and (4) To describe and compare formal care resources (e.g., home health) utilized by hip fracture and non-hip fracture subjects. Hip fracture causes significant mortality, morbidity, and disability among older adults. It has been demonstrated that the majority of hip fracture patients do not regain their prefracture level of functioning at one-year post surgery. The loss of functional independence imposes heavy burden on individuals, caregivers, and society as a whole. Physical function recovery in activities of daily living (ADLs)and instrumental activities of daily living (IADLs) one year postsurgery is well established, however, little is known about how changes in physiological function, functional limitation, and functional disability contribute to the disablement process among older adult hip fracture patients, and how health care resources are used to compensate for their deficit in function in order to remain in the community. The proposed research will utilize a 3-year longitudinal data from the Women's Health and Aging Study (1992-1998) and the Medicare Current Beneficiaries Survey (1992-1995). The results of this study will provide a natural history of disablement process among hip fracture patients and a basis for predicting long-term health care needs by post-hip fracture patients as their disability progresses. Finding will be useful to guide future intervention programs ,through which to foster functional independence by slowing down the disablement process.