Division of Physical and Rehabilitation Medicine, Osteoporosis Research Center, Fondazione Opera San Camillo, Presidio di Torino, strada Santa Margherita 136, 10131, Turin, Italy.
Neuropsychology Service, Fondazione Opera San Camillo, Presidio di Torino, Turin, Italy.
Aging Clin Exp Res. 2022 Dec;34(12):2977-2984. doi: 10.1007/s40520-022-02233-6. Epub 2022 Sep 3.
Cognitive impairment assessed by easy-to-administer tests successfully predicts function after hip fracture, whereas the prognostic role of additional cognitive evaluations is largely unknown.
To investigate the capability of further assessments to discriminate cognitive impairment with prognostic relevance in hip-fracture women defined cognitively intact or mildly impaired on the Short Portable Mental Status Questionnaire (SPMSQ).
We prospectively investigated women with subacute hip fracture admitted to our rehabilitation facility. The women who made ≤4 errors on the SPMSQ were further assessed by 4 tests: Montreal Cognitive Assessment, Rey Auditory Verbal Learning Test (immediate and delayed recall) and Frontal Assessment Battery. Activities of daily living (ADL) were measured by the Barthel index. Successful rehabilitation was defined with a Barthel index score ≥85.
Data from 127 women were available. Each of the 4 cognitive tests assessed at admission significantly predicted the Barthel index scores measured at discharge. The predictive role persisted after multiple adjustments. For a change in cognitive scores corresponding to the difference between 25° and 75° percentiles in their distribution in the sample, the adjusted odds ratio to achieve successful rehabilitation roughly ranged from 2 to 4, depending on which cognitive test was adopted.
The women with subacute hip fracture defined cognitively intact or mildly impaired on the SPMSQ could have cognitive impairment revealed by further examination, with prognostic disadvantages in ADL.
Assessing cognition by the SPMSQ seems not enough to exclude the presence of cognitive impairment with relevant prognostic disadvantage in hip-fracture women.
通过易于管理的测试评估认知障碍可以成功预测髋部骨折后的功能，而其他认知评估的预后作用在很大程度上尚不清楚。
调查进一步评估在短便携精神状态问卷（SPMSQ）定义为认知正常或轻度受损的髋部骨折女性中区分具有预后相关性的认知障碍的能力。
我们前瞻性地调查了入住我们康复机构的亚急性髋部骨折女性。在 SPMSQ 上犯 ≤4 个错误的女性进一步接受了 4 项测试的评估：蒙特利尔认知评估、 Rey 听觉言语学习测试（即时和延迟回忆）和额叶评估量表。日常生活活动（ADL）通过 Barthel 指数进行测量。Barthel 指数评分 ≥85 定义为康复成功。
共有 127 名女性的数据可用。入院时进行的每项认知测试均显著预测了出院时测量的 Barthel 指数评分。在多次调整后，该预测作用仍然存在。对于认知评分的变化，对应于样本分布中第 25 至 75 百分位数之间的差异，采用不同认知测试时，成功康复的调整后优势比大致在 2 到 4 之间。
SPMSQ 定义为认知正常或轻度受损的亚急性髋部骨折女性可能存在认知障碍，这对 ADL 有不利的预后影响。
通过 SPMSQ 评估认知似乎不足以排除髋部骨折女性存在具有相关预后不利的认知障碍。
