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Am J Epidemiol 2003; 157:1023-1031.
Copyright © 2003 by Johns Hopkins Bloomberg School of Public Health


ORIGINAL CONTRIBUTIONS

Changes in Functional Status Attributable to Hip Fracture: A Comparison of Hip Fracture Patients to Community-dwelling Aged

Jay Magaziner1,, Lisa Fredman2, William Hawkes1, J. Richard Hebel1, Sheryl Zimmerman3, Denise L. Orwig1 and Lois Wehren1

1 Department of Epidemiology and Preventive Medicine, School of Medicine, University of Maryland, Baltimore, MD.
2 Department of Epidemiology and Biostatistics, School of Public Health, Boston University, Boston, MA.
3 School of Social Work, University of North Carolina, Chapel Hill, NC.

Disability attributable to hip fracture regarding activities of daily living was evaluated by comparing 594 hip fracture patients entering eight hospitals in Baltimore, Maryland, in 1990–1991 with community-dwelling aged from the Established Populations for Epidemiologic Studies of the Elderly (EPESE) cohort matched on age, sex, and walking ability. Subjects were assessed at baseline (prefracture report for patients), 12 months, and 24 months. At baseline, 26% of both groups had walking disability, 12–14% had transferring disability, and 6–8% evidenced grooming disability. At 12 and 24 months, about 50% of hip fracture patients were walking disabled compared with 21–29% of EPESE respondents after the authors controlled for age, sex, comorbidities, and functional status (excess disability attributable to hip fracture, i.e., attributable disability, of 26 additional cases of disability per 100 persons in the hip fracture cohort during follow-up). Likewise, hip fracture patients experienced more disability regarding transferring (38–39% vs. 10–18%; attributable disability, approximately 22 cases per 100 persons) and grooming (17–19% vs. 7–15%; attributable disability, approximately six cases per 100 persons). Thus, results showed that hip fracture patients had substantially more activities of daily living disability than that explained by aging over 24 months.

activities of daily living; aging; disability evaluation; disabled persons; hip fractures

Abbreviations: Abbreviations: ADL, activities of daily living; BHS, Baltimore Hip Studies; EPESE, Established Populations for Epidemiologic Studies of the Elderly.


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