• Bodil Samuelsson, Margareta I Hedström, Sari Ponzer, Anita Söderqvist, Eva Samnegård, Karl-Göran Thorngren, Tommy Cederholm, Maria Sääf, and Nils Dalen.
• Division of Orthopaedics, Department of Clinical Science, Karolinska Institutet, Danderyd Hospital, SE-18288 Stockholm, Sweden. bodil.samuelsson@shh.se
• Age Ageing. 2009 Nov 1;38(6):686-92.

Backgroundhip fractures as well as cognitive dysfunction become increasingly prevalent in growing ageing populations. Hip fractures are approximately three times more common in elderly women.Objectivewe analysed outcome after hip fracture with respect to gender and cognitive function.Designpopulation-based, prospective cohort study.Settingfour university hospitals in Stockholm, Sweden.Subjectsa total of 2,134 consecutive patients admitted with hip fracture during 2003.Methodsgender differences in residence, walking ability and activity of daily living (ADL) were analysed at baseline, after 4 and 24 months in patients with and without intact cognitive function.Resultswomen were older, more often living alone and had poorer walking ability (P < 0.001). Cognitive dysfunction was equally common by gender. Women were more often treated with a prosthesis (P < 0.001) and sent to rehabilitation (P < 0.001). In the cognitive dysfunction group, men had more co-morbidity (P < 0.001) and total loss of walking ability (P = 0.03), but more often resided in own homes (P = 0.03). There was no gender difference in ADL.Conclusionmen had a higher risk for loss of walking ability and death only in patients with cognitive dysfunction. Cognitive function was the most important factor for returning to own home and regain pre-fracture function.

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