Consequences of fall-induced hip fractures on cognitive function, physical activity, and mortality: Korean longitudinal study of aging 2006-2016

Background: Few studies have investigated the consequences of fall-induced hip fractures among healthy, community-dwelling middle-aged adults. Objectives: To investigate the effects of fall-induced hip fractures on cognitive function, activities of daily living, and mortality from the time the fractures increase. Design: A secondary data analysis based on data from the Korean Longitudinal Study of Aging (2006-2016). Methods: Participants were 8,571 people over 45 years in South Korea who had never experienced a fall-induced hip fracture by 2006. Participants were divided into a hip-fracture group (those who experienced one or more hip fractures between 2008 and 2016; N = 306), and a non-hip-fracture group (those who did not experience a hip fracture during this period; N = 8,265). A linear mixed model, Kaplan-Meier analysis, and Cox regression were used to analyze the effects of hip fractures on mortality, the Mini Mental State Examination, Activities of Daily Living, and Instrumental Activities of Daily Living scores during 2008-2016. Results: In the hip-fracture group, compared to the non-fracture group, the change in Mini Mental State Examination score was significantly greater (p = 001); however, although there was a significant difference at each time point (p < .001), the cumulative difference over time was not significant (p = .560). The hip-fracture group showed a faster time to initial decline in Mini Mental State Examination scores (hazard ratio = 1.16, CI = 1.022-1.318). The hip-fracture group showed significantly larger changes in Activities of Daily Living and Instrumental Activities of Daily Living scores (p < .001), shorter time until decline began (p < .001), and larger decline as time passed (p < .001). Furthermore, the time before assistance was required from others for activities of daily living and instrumental activities of daily living was also shorter (hazard ratio = 2.18, CI= 1.728-2.759; odds ratio = 1.44, CI = 1.198-1.732). Hip fractures also increased mortality (hazard ratio = 1.42, CI = 1.013-2.002). Conclusions: Our study found that hip fractures accelerate the decline of cognitive function, physical activity, and increased mortality. Our findings can be used to develop fall-prevention programs.restrictio