The impact of cognitive function on physical activity, physical function and quality of life in older adults following a hip fracture

• Published in: Age and ageing Vol. 52; no. 4
• Main Authors: Runde, Henrik A, Taraldsen, Kristin, Follestad, Turid, Saltvedt, Ingvild, Johnsen, Lars G
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.04.2023; Oxford Publishing Limited (England)
• Subjects: Activities of Daily Living; Aged; Cognition; Cognitive ability; Cognitive functioning; Comorbidity; Exercise; First year; Fractured hips; Fractures; Health status; Hip; Hip Fractures - surgery; Hip joint; Humans; Mini-Mental State Examination; Older people; Physical ability; Physical activity; Quality of life; Quality of Life - psychology; Regression analysis; Research Paper; Surgery; cognitive function; physical function; health-related quality of life; older people; hip fracture; physical activity
• ISSN: 0002-0729; 1468-2834
• DOI: 10.1093/ageing/afad061

Abstract Objective To determine the impact of cognitive function on physical activity (PA), physical function and health-related quality of life (HRQoL) in older adults within the first year after hip fracture (HF) surgery. Methods We included 397 home-dwelling individuals aged 70 years or older with the ability to walk 10 m before the fracture. Cognitive function was measured at 1 month and other outcomes were assessed at 1, 4 and 12 months postoperatively. Mini-Mental State Examination was used to assess cognitive function, accelerometer-based body-worn sensors to register PA, Short Physical Performance Battery to test physical function and EuroQol-5-dimension-3-level to estimate the HRQoL. Data were analysed by linear mixed-effects models with interactions and ordinal logistic regression models. Results Cognitive function, adjusted for the pre-fracture ability to perform activities of daily living, comorbidity, age and gender, had an impact on PA [b = 3.64, 95% confidence interval (CI): 2.20–5.23, P < 0.001] and physical function (b = 0.08, 95% CI: 0.04–0.11, P < 0.001; b = 0.12, 95% CI: 0.09–0.15, P < 0.001; and b = 0.14, 95% CI: 0.10–0.18, P < 0.001 at 1, 4 and 12 months, respectively). The cognitive function did not have a considerable impact on HRQoL. Conclusions For older adults with HFs, cognitive function 1 month postoperatively had a significant impact on PA and physical function in the first postoperative year. For the HRQoL, little or no evidence of such an effect was found.