Another of dementia’s horrible, yet hidden, costs has been exposed as researchers in Canada claim to have found a solid link between dementia and hip fractures.
A team of researchers crunched data on nearly 46,000 elders’ hip fractures in Ontario between 2003 and 2010 and found that people with dementia accounted for more than four-fifths of hip fractures in long term care centers and nearly one-quarter of hip fractures in the community.
Several previous studies have shown that those with dementia who break their hip are more likely to die, and more quickly, than their peers. Now researchers believe they’ve shown just how close those with dementia are to a hip-related terminal drop.
“Information from our study provides important insights about the impact of dementia on hip fracture management and outcomes from a population-based perspective,” corresponding author Dallas Seitz, MD, writes for his colleagues. “These findings are important for clinicians, health care administrators, and policymakers.”
The team’s findings were published in the latest edition of the Journal of the American Medical Directors Association. It’s a further addendum to dementia’s butcher bill, which already costs billions—counted and uncounted—in direct and indirect channels.
Based on the breadth and depth of the team’s data, Seitz and his colleagues believe they’ve found further evidence that those with dementia “are a high-risk group who likely require specialized care processes” from the moment they come out of surgery.
“Dementia was associated with a further increase in risk of poor post-operative outcomes, including elevated rates of [long term care] placement and mortality,” Seitz says. “Given the common occurrence of hip fractures among individuals with dementia, clinicians should institute processes to prevent hip fractures in this population.”
There are several reasons why a hip fracture can be deadly for someone already struggling with dementia, Seitz and his colleagues believe.
“Dementia is an independent risk factor for the development of some post-operative complications such as delirium, which is also a major risk factor for post-operative mortality,” Seitz says. “Part of the increased risk may have been due to individuals with dementia having greater severity of medical comorbidity, although an elevated risk of death associated with dementia continued to be observed after controlling for these factors.”
Here is where long term care centers may have an advantage, though, Seitz says. Those with dementia who lived in their communities were more likely to die after a hip fracture, the team found. But that may be because they’re not subject to the same professional (and rigorous) rehab programs that care centers offer, the team says.
“Given the poor prognosis associated with hip fractures in older adults with dementia, increased efforts to prevent fractures and decrease post-operative complications for this population are required,” Seitz says.
(Bill Myers is Provider’s senior editor. Email him at firstname.lastname@example.org. Follow him on Twitter, @ProviderMyers.)