Functional recovery among elderly people one year after hip fracture surgery

The purposes of the present study were to follow up on the recovery of activities of daily living (ADL) and instrumental activities of daily living (IADL) one year after hip fracture in elderly people and to understand the factors that affect functional recovery. Information for this one-year study was obtained through structured interviews during the first week after admission, at discharge, three months and one year after fracture. One hundred and three elderly people over 65 years old, with femoral neck fractures and intertrochanteric fractures due to falling down were recruited from a medical center in Taipei. The results were as follows: In most cases, ADL and IADL in elderly people could not be recovered to the status before fracture in the one-year period of follow-up; the most rapid recovery period was within three months after discharge. In terms of ADL before fracture, 93.2%, 74.8%, and about 90% of patients could walk, climb stairs, and take care of themselves (feeding, toileting, dressing), respectively; however, only 70.9%, 49.1% and about 75% of patients respectively could walk, climb stairs and take care of themselves one year after hip fracture. As for IADL, 73.8% of patients could walk outdoors before fracture, but only 58.2% could walk outdoors one year after fracture. The factor on which ADL recovery within one year after hip fracture depended was the ability to walk outdoors before fracture. It explained 39.7% of total variance in ADL. As for IADL, significant predictors included doing housework, marital status and use of walking aids before fracture. These items explained 56.1% of total variance in IADL. The findings point to the functional decline of elderly people after hip fracture and suggest the importance of focusing on hospital-based multidisciplinary interventions and discharge planning.