Hack Juliana, Eschbach Daphne, Aigner Rene, Oberkircher Ludwig, Ruchholtz Steffen, Bliemel Christopher, Buecking Benjamin
1 Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Marburg, Germany.
J Geriatr Psychiatry Neurol. 2018 Mar;31(2):84-89. doi: 10.1177/0891988718760240. Epub 2018 Mar 21.
The aim of this study was to identify factors that are associated with cognitive decline in the long-term follow-up after hip fractures in previously nondemented patients.
A consecutive series of 402 patients with hip fractures admitted to our university hospital were analyzed. After exclusion of all patients with preexisting dementia, 266 patients were included, of which 188 could be examined 6 months after surgery. Additional to several demographic data, cognitive ability was assessed using the Mini-Mental State Examination (MMSE). Patients with 19 or less points on the MMSE were considered demented. Furthermore, geriatric scores were recorded, as well as perioperative medical complications. Mini-Mental State Examination was performed again 6 months after surgery.
Of 188 previously nondemented patients, 12 (6.4%) patients showed a cognitive decline during the 6 months of follow-up. Multivariate regression analysis showed that age ( P = .040) and medical complications ( P = .048) were the only significant independent influencing factors for cognitive decline.
In our patient population, the incidence of dementia exceeded the average age-appropriate cognitive decline. Significant independent influencing factors for cognitive decline were age and medical complications.
本研究旨在确定在既往无痴呆的患者髋部骨折长期随访中与认知功能下降相关的因素。
对我院收治的402例髋部骨折患者进行连续分析。排除所有既往有痴呆的患者后，纳入266例患者，其中188例在术后6个月接受检查。除了多项人口统计学数据外，使用简易精神状态检查表（MMSE）评估认知能力。MMSE得分在19分及以下的患者被视为痴呆患者。此外，记录老年评分以及围手术期医疗并发症。术后6个月再次进行简易精神状态检查表检查。
在188例既往无痴呆的患者中，12例（6.4%）患者在6个月的随访期间出现认知功能下降。多因素回归分析显示，年龄（P = 0.040）和医疗并发症（P = 0.048）是认知功能下降的仅有的显著独立影响因素。
在我们的患者群体中，痴呆的发生率超过了与年龄相关的平均认知功能下降水平。认知功能下降的显著独立影响因素是年龄和医疗并发症。
