Journal of the American Medical Directors Association
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To evaluate the association between dementia and postoperative outcomes of older adults with hip fractures. ⋯ Dementia is common among older adults with hip fractures and associated with poor prognosis following hip fracture surgery. Specialized services targeting the growing number of older adults with dementia may help to prevent hip fractures and optimize postoperative care for this vulnerable population.
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Randomized Controlled Trial Comparative Study
Effects of a multicomponent home-based physical rehabilitation program on mobility recovery after hip fracture: a randomized controlled trial.
To investigate whether a home-based rehabilitation program for community-dwelling older people with recent hip fracture is more effective than standard care in improving mobility recovery and reducing disability. ⋯ The individualized home-based rehabilitation program improved mobility recovery after hip fracture over standard care. To be efficacious in reducing or reversing disability after hip fracture, rehabilitation needs to be individualized, include many components, be progressive, and span a sufficiently long period. Current Controlled Trials (ISRCTN53680197).
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Delirium superimposed on dementia (DSD) is common in many settings. Nonetheless, little is known about the association between DSD and clinical outcomes. The study aim was to evaluate the association between DSD and related adverse outcomes at discharge from rehabilitation and at 1-year follow-up in older inpatients undergoing rehabilitation. ⋯ DSD is a strong predictor of functional dependence, institutionalization, and mortality in older patients admitted to a rehabilitation setting, suggesting that strategies to detect DSD routinely in practice should be developed and DSD should be included in prognostic models of health care.
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To provide a new instrument to diagnose frailty, the Frailty Trait Scale (FTS), that allows a more precise assessment and monitoring of individuals. ⋯ FTS associates with many of the factors linked to frailty and has a similar predictive capacity to that provided by the classical instruments. Its characteristics offer some advantages over them, with potential utility in research and clinical practice.
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Delirium superimposed on dementia (DSD) is frequently not diagnosed, at great cost. Both delirium and dementia are associated with cerebral hypoperfusion. A switch to anaerobic glycolysis in the central nervous system during delirium compared to Alzheimer's dementia (AD) suggests greater hypoperfusion in DSD. The main aims of this study were to investigate whether cerebral hypoperfusion could differentiate DSD from related entities, and the characteristics of that hypoperfusion. ⋯ Transcranial Doppler is a potential diagnostic and monitoring test for DSD. Correlation with clinical indicators of delirium suggests pathophysiological significance.