• G I Kempen, W Scaf-Klomp, A V Ranchor, R Sanderman, and J Ormel.
• Department of Health Care Studies, Section of Medical Sociology, Maastricht University, The Netherlands. G.Kempen@zw.unimaas.nl
• J Gerontol B Psychol Sci Soc Sci. 2001 Jul 1; 56 (4): S229-36.

ObjectivesThe impact of educational level and social support on short-term and long-term recovery of activities of daily living and instrumental activities of daily living after injuries to the extremities was examined in a prospective study concerning late middle-aged and older persons.MethodsPatients (N = 171) who had sustained fall-related injuries (hip fractures, other fractures, or sprains and dislocations) participated in the study. Disability scores were collected at baseline (before the injury) and 8 weeks, 5 months, and 12 months after the injury. The authors used analysis of variance to assess possible differences between 3 levels of education and social support with respect to changes in disability scores from baseline to the 3 follow-up measurements while adjusting for covariates.ResultsPreinjury assessed educational level or social support did not play a role in short-term changes in disability. In the long term (5 and 12 months after the injury), recovery was significantly associated with social support: Those with higher levels of support had a better recovery. Although patients with high levels of education most closely approached their pre-event level of disability as well, differences did not reach statistical significance. Short-term changes in disability appeared to be determined by the severity of the injury. Social support began to influence recovery only when the impact of severity expired.DiscussionPatients recovering from fall-related injuries who had reported high levels of social support before their injury had recovered better at 5 and 12 months. Encouragement and special attention given by health professionals to maintain social support may be beneficial for rehabilitation after fall-related injuries in older persons.

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