Center on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland; University Clinic for Acute Geriatric Care, Waid City Hospital, Zurich, Switzerland.
Center on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland; Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, Switzerland.
J Am Med Dir Assoc. 2018 Feb;19(2):122-129. doi: 10.1016/j.jamda.2017.08.009. Epub 2017 Sep 30.
After a hip fracture, 50% of senior patients are left with permanent functional decline and 30% lose their autonomy. The aim of this prospective study was to evaluate whether seniors who are in a caregiver role have better functional recovery after hip fracture compared with noncaregivers.
Prospective observational study.
A total of 107 Swiss patients with acute hip fracture age 65 years and older (84% women; 83.0 ± 6.9 years; 87% community-dwelling).
At baseline, participants were asked if they were caregivers for a person, a pet, or a plant. Lower-extremity mobility was measured using the Timed Up and Go (TUG) test at baseline during acute care (day 1-12 after hip fracture surgery) and at 6 and 12 months follow-up. Subjective physical functioning (SPF) was rated for prefracture values and at 6 and 12 months follow-up using the Short Form 36 Health Survey questionnaire. Differences in TUG performance or SPF between caregivers and noncaregivers at 6 and 12 months were assessed using multivariable repeated-measures analysis adjusted for age, sex, body mass index, Charlson comorbidity index, Mini-Mental State Examination, living condition, baseline TUG, and treatment (vitamin D, home exercise program as part of the original trial).
At baseline, adjusted TUG performance was better in caregivers of any kind compared with noncaregivers (40.9 vs 84.4 seconds, P < .0001). At 6 months, and after adjustment for baseline TUG performance and other covariates, TUG was better in caregivers of any kind (-6.4 seconds, P = .007) and caregivers of plants (-6.6 seconds, P = .003) compared with noncaregivers. At 12 months, only caregivers of persons had better TUG performance compared with noncaregivers (-7.3 seconds, P = .009). Moreover, at 12 months, SPF was better in caregivers of persons (58.9 vs 45.6, P = .01) and caregivers of any kind (50.8 vs 39.3, P = .02) compared with noncaregivers.
Senior hip fracture patients who have a caregiver role of any kind, and especially of plants, had better short-term recovery after hip fracture assessed with the TUG. For long-term recovery, senior hip fracture patients who are caregivers for other persons appeared to have a significant benefit. These benefits were independent of baseline function and all other covariates.
髋部骨折后，50%的老年患者会永久性地出现功能下降，30%的患者会丧失自理能力。本前瞻性研究旨在评估髋部骨折后，照顾者与非照顾者相比，其功能恢复情况是否更好。
前瞻性观察性研究。
共纳入 107 名瑞士急性髋部骨折老年患者（年龄≥65 岁；84%为女性；83.0±6.9 岁；87%为社区居住）。
在基线时，参与者被问及他们是否照顾过某个人、宠物或植物。使用计时起立行走（TUG）测试在急性护理期间（髋部骨折手术后 1-12 天）和 6 个月及 12 个月随访时测量下肢移动能力。使用健康调查简表 36 项（SF-36）问卷在基线时和 6 个月及 12 个月随访时评估主观身体功能（SPF）。使用多变量重复测量分析评估 6 个月和 12 个月时 TUG 表现或 SPF 在照顾者和非照顾者之间的差异，调整因素包括年龄、性别、体重指数、Charlson 合并症指数、简易精神状态检查、居住条件、基线 TUG 和治疗（维生素 D、家庭运动计划作为原始试验的一部分）。
在基线时，与非照顾者相比，任何类型的照顾者 TUG 表现更好（40.9 秒 vs 84.4 秒，P＜0.0001）。在 6 个月时，调整基线 TUG 表现和其他协变量后，任何类型的照顾者（-6.4 秒，P=0.007）和植物照顾者（-6.6 秒，P=0.003）的 TUG 表现均优于非照顾者。在 12 个月时，只有照顾者的 TUG 表现优于非照顾者（-7.3 秒，P=0.009）。此外，在 12 个月时，与非照顾者相比，照顾者的 SPF 更好（58.9 分 vs 45.6 分，P=0.01），任何类型的照顾者的 SPF 也更好（50.8 分 vs 39.3 分，P=0.02）。
髋部骨折后，任何类型的照顾者（尤其是照顾植物的照顾者），在髋部骨折后使用 TUG 评估时，短期恢复情况更好。对于长期恢复，照顾他人的髋部骨折老年患者似乎有显著获益。这些获益与基线功能和所有其他协变量无关。
