Men more at risk for cognitive impairment, death after hip fracture


After a hip fracture, men are more cognitively impaired and therefore more at risk of death than women, researchers in Baltimore say.

In 2025 the number of hip fractures in men as high as what is currently seen in women, the researchers warn.

That makes these fractions are “an emerging public health concern for older men, their families, and the healthcare system,” said Dr. Ann Gruber-Baldini University of Maryland School of Medicine, and her colleagues. “In comparison with women, men who have a hip fracture have an increased risk of mortality . . . despite their young age at the time of the breach.”

As reported in the Journal of the American Geriatrics Society, the researchers compared the effects of a hip fracture on the thinking skills and risk of death in the 166 men and 168 women over the age of 80.

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The men had significantly more other diseases to begin with, and more of them were diagnosed with dementia. Also, men were significantly more impaired on most cognitive measures.

After taking a pre-fracture dementia and other risk factors are taken into account, men were still at a significantly higher risk for poor scores on a large number of tests of thinking skills.

Also, men had a higher mortality rate than women six months after hip fracture – and the men of the scores on the cognitive tests were significantly associated with the risk of death: those who did poorly on the tests were more likely to die during the study.

On a common test – the modified Mini-Mental-State – Exam – almost a third of the men with poor scores died within six months, compared with 15 percent of the women with poor scores and 11 percent of men with no cognitive problems. By contrast, only 2 percent of the women without cognitive problems on this test died within six months.

No significant interaction effect between gender and cognition.

Gruber-Baldini told Reuters Health, “It may be valuable for doctors to monitor hip fracture patients after discharge from hospital – especially men – to see if they still suffer from cognitive impairment and the consequences of the delirium.”

“Interventions to reduce delirium – evaluation of drugs, nutrition, infections, and comorbid conditions – may be required,” she said by e-mail. “It is also important that people with cognitive impairment for rehabilitation to help improve their mobility.”

Orthopedic surgeon Dr. John Tiberi of the Kerlan-Jobe Orthopaedic Clinic in Los Angeles, California, told Reuters Health, “hip fractures in the elderly are known to have significant risks, even after adequate treatment.”

“This research underscores the increasing incidence of hip fractures in men and higher rates of a number of negative outcomes in men compared with women,” he said by e-mail. “Knowledge of these findings can better help carers and family members in providing care and support for hip fracture patients during the incredibly important for the recovery and rehabilitation process.”

SOURCE: Journal of the American Geriatrics Society, online February 8, 2017.

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