Predictors of functional recovery for hip fractured elders during 12 months following hospital discharge: a prospective study on a Taiwanese sample

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Abstract
To examine the longitudinal changes in overall and individual physical activities of daily living (PADLs) and instrumental activities of daily living (IADLs), at 1, 3, 6, and 12 months after hospital discharge in elderly subjects, 110 hip fractured elders (mean±SD age, 79.4±7.5; 60.9% females) were enrolled in a prospective study. At 12 months following hospital discharge, 56.1% subjects had recovered their overall PADLs, 37.9% had recovered their overall IADLs, and 74.2% could walk independently or with the aide of a cane. When analyzed by generalized estimating equations (GEE), for individual PADL, bathing and climbing stairs had consistently improved at every time point throughout the 1-year follow-up period, while transferring, toileting, and walking ability only improved significantly in the first 3 months after discharge. For individual IADL, the proportion of recovery for mobility appeared to increase significantly during the first 6 months post-discharge, and the remaining IADLs appeared to be stable. These results indicated that the recovery rate is varied for performance of different activities according to the complexity and the involvement of the lower extremities. We also found that less concomitant diseases, and a shorter hospital stay could predict a better recovery trend of overall and of most individual PADLs. These findings may be applicable to other countries with Chinese populations, and could provide a reference for health care providers to develop specific interventions for Chinese hip fractured elders.