EPIDEMIOLOGY--DETERMINANTS OF RECOVERY FROM HIP FRACTURE

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Hip fracture represents a major health problem facing the aged. The burdens of hip fracture to the elderly, their families and the health care system are great. Still, many individuals fracturing a hip recover, though some more fully than others. Furthermore, many medical and psychosocial factors are believed to influence survival and recovery following a hip fracture, though prior research in this area is seriously lacking. The purpose of the proposed project is to determine the influence of medical and psychosocial factors on survival and on recovery in physical capacity, functional independence and social interaction during the year following a hip fracture in community dwellers aged 65+. While many medical factors influence recovery, this project will focus on potentially modifiable determinants of recovery such as: preoperative medical and cognitive status; peri and post- operative complications; postfracture cognitive, affective and attitudinal status; family and friend involvement in recovery; and therapeutic interventions. These issues will be addressed through a prospective epidemiological investigation of approximately 500 hip fracture patients over age 65. Information on pre and post-fracture status will be obtained from significant others, hospital nurses and medical records. Surviving patients will be assessed at their place of residence at 1, 3, 6, and 12 months post-fracture by an individual trained in physical assessment techniques. During this examination, the evaluator will assess physical capacity {range of motion, gait, balance}, functional independence in ability to perform tasks of daily living, and will obtain information needed to evaluate mental and social functioning. Data will be analyzed using multivariate techniques which will enable an understanding of how medical and psychosocial factors impact on survival and recovery in physical capacity, functional independence and social interaction during the year following the injury.