TY - JOUR
T1 - Cognitive Improvement in Older Adults in the Year After Hip Fracture
T2 - Implications for Brain Resilience in Advanced Aging
AU - Oughli, Hanadi Ajam
AU - Chen, Gengsheng
AU - Philip Miller, J.
AU - Nicol, Ginger
AU - Butters, Meryl A.
AU - Avidan, Michael
AU - Stark, Susan
AU - Lenze, Eric J.
N1 - Funding Information:
Meryl A. Butters, Ph.D., has received research support from NIH. Ginger Nicol, M.D., receives or has received research support from NIMH, the Sidney R. Baer, Jr., Foundation, the Center for Brain Research in Mood Disorders at Washington University, and Otsuka America, Inc., for investigator-initiated research studies. She has served as principal or co-investigator on industry-sponsored clinical trials funded by Alkermes, Takeda, and Shire. Michael Avidan, M.B.B.Ch., reports no financial conflicts.
Funding Information:
This publication was supported by funding to Eric J. Lenze, M.D., from NIMH (R01 MH074596) and Washington University Institute of Clinical and Translational Sciences grant UL1TR000448, from the National Center for Advancing Translational Sciences of NIH, the Taylor Family Institute for Innovative Psychiatric Research, and the Center for Brain Research in Mood Disorders (Washington University). The funding source(s) had no role in the preparation, review, or approval of the manuscript.
Funding Information:
Eric J. Lenze, M.D., has received research support from NIH, the U.S. Food and Drug Administration, the McKnight Brain Research Foundation, the Taylor Family Institute for Innovative Psychiatric Research, the Center for Brain Research in Mood Disorders (Department of Psychiatry, Washington University), the Barnes-Jewish Foundation, Janssen, Alkermes, Takeda, and Lundbeck. J. Philip Miller, A.B., has received research support from NIH, the U.S. Food and Drug Administration, and the Patient-Centered Outcomes Research Institute. Susan Stark, Ph.D., has received research support from NIH, the Centers for Disease Control and Prevention, the U.S. Department of Housing and Urban Development, ACL, the Barnes-Jewish Foundation, and Toto.
Publisher Copyright:
© 2018 Elsevier Ltd
PY - 2018/11
Y1 - 2018/11
N2 - Objective: We examined cognitive function in nondemented, nondelirious older adults 1 year post hip fracture. Design: Prospective observational study. Setting and Participants: Three hundred eighty-six hip fracture patients aged 60 years and older with no history of cognitive impairment, such as clinical dementia or persistent delirium, recruited from eight area hospitals 2–3 days after hip surgery (week 0), and 101 older adults with no recent acute medical events for control comparison. Methods: Cognitive function was examined with the Repeatable Battery for the Assessment of Neuropsychological Status and the Short Blessed Test (SBT) at weeks 0 (SBT only), 4, and 52 using a repeated measures mixed model analysis. Baseline predictor variables included demographics, personality, genetic factors, and depressive symptom level. Results: Hip fracture participants had lower cognitive scores than healthy comparisons. Cognitive scores improved in the hip fracture group relative to healthy comparison participants from week 4–52. The only significant predictor of cognitive improvement after hip fracture was education: individuals with college education showed cognitive improvement by week 52, while those with high school or less did not. Conclusion: Nondemented, nondelirious older adults suffering hip fracture have poorer cognitive function immediately after the fracture but then exhibit cognitive improvement over the ensuing year, especially among those with high education. This demonstrates brain resilience in older adults even in the context of advanced age, medical illness, and frailty.
AB - Objective: We examined cognitive function in nondemented, nondelirious older adults 1 year post hip fracture. Design: Prospective observational study. Setting and Participants: Three hundred eighty-six hip fracture patients aged 60 years and older with no history of cognitive impairment, such as clinical dementia or persistent delirium, recruited from eight area hospitals 2–3 days after hip surgery (week 0), and 101 older adults with no recent acute medical events for control comparison. Methods: Cognitive function was examined with the Repeatable Battery for the Assessment of Neuropsychological Status and the Short Blessed Test (SBT) at weeks 0 (SBT only), 4, and 52 using a repeated measures mixed model analysis. Baseline predictor variables included demographics, personality, genetic factors, and depressive symptom level. Results: Hip fracture participants had lower cognitive scores than healthy comparisons. Cognitive scores improved in the hip fracture group relative to healthy comparison participants from week 4–52. The only significant predictor of cognitive improvement after hip fracture was education: individuals with college education showed cognitive improvement by week 52, while those with high school or less did not. Conclusion: Nondemented, nondelirious older adults suffering hip fracture have poorer cognitive function immediately after the fracture but then exhibit cognitive improvement over the ensuing year, especially among those with high education. This demonstrates brain resilience in older adults even in the context of advanced age, medical illness, and frailty.
KW - Hip fracture
KW - cognitive decline
KW - delirium
UR - http://www.scopus.com/inward/record.url?scp=85054733247&partnerID=8YFLogxK
U2 - 10.1016/j.jagp.2018.07.001
DO - 10.1016/j.jagp.2018.07.001
M3 - Article
C2 - 30454790
AN - SCOPUS:85054733247
SN - 1064-7481
VL - 26
SP - 1119
EP - 1127
JO - American Journal of Geriatric Psychiatry
JF - American Journal of Geriatric Psychiatry
IS - 11
ER -