RecruitingNot ApplicableNCT06286722

Optimized Rehabilitation of Older Adults With Hip Fracture and Signs of Cognitive Impairment - Feasibility Study

Optimized Rehabilitation of Older Adults With Hip Fracture and Signs of Cognitive Impairment - the ENHANCE Project - Feasibility Study


Sponsor

Lolland Community, Denmark

Enrollment

20 participants

Start Date

Feb 8, 2024

Study Type

INTERVENTIONAL

Conditions

Summary

Older adults suffering from a hip fracture are a significant concern, with higher incidence rates among women. Mortality rates post-hip fracture are alarming, with up to 8-fold increased risk within 3 months and significant percentages within 30 days and 12 months. Older adults with hip fracture face challenges in regaining pre-fracture level of function, especially those with cognitive impairment, which affects 25% to 40% of cases and increases mortality risk. While interventions exist, such as progressive strength training and structured exercise programs, patients with hip fracture don't consistently restore pre-fracture function, particularly in cognitively impaired patients, who are often excluded from studies. Limited evidence exists on effective management for this subgroup, with a lack of clarity on community-based rehabilitation. Although guidelines suggest exercise interventions for patients with mild to moderate cognitive impairment, the specifics remain uncertain due to insufficient research focused solely on this population. This feasibility study aims to assess the practicality and safety of implementing a 12-week individualized, progressive exercise program for older adults with hip fracture and cognitive impairment in an outpatient setting. Additionally, the investigators seek to gather qualitative insights through observations and interviews regarding participants' experiences and the perceived value of rehabilitation post-hip fracture, particularly focusing on the exercise intervention provided.


Eligibility

Min Age: 65 Years

Inclusion Criteria5

  • Recently (within 3 weeks) underwent surgical repair of a hip fracture (femoral neck or trochanteric fracture)
  • Independent pre-fracture ambulatory function (≥2 on the New Mobility Score on indoor walking)
  • Having signs of cognitive impairment measured with the Mini-Mental Score Examination of <24 points, or a verified dementia diagnosis, or on information from the patient record
  • Living in their own home, nursing home, or assisted living facilities
  • Informed consent by patient

Exclusion Criteria9

  • Pathological hip fracture
  • Having signs of severe dementia measured with the Mini-Mental State Examination (<10 points)
  • Non-Danish speaking
  • Patients with an unstable health condition (e.g. not treated high blood pressure (>180 mm HG)) evaluated by medical consultant
  • "Safety concerns" (e.g. underlying comorbidities that might be associated with serious adverse events) - not safe to participate in the opinion of the investigator
  • Having behavioral or psychotic disorders
  • Alcohol or drug abuse
  • Unable to participate in the intervention (e.g. due to blindness, no language)
  • Patients with any weight-bearing restrictions after surgery

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Interventions

OTHERProgressive, individualized and structured exercise program

See description under Arms


Locations(6)

Frederiksberg Healthcare center and 24-hour rehabilitation

Frederiksberg, Denmark

Stevns Healthcare Center, Stevns Municipality

Hårlev, Denmark

Hørsholm Health and Rehabilitation Center

Hørsholm, Denmark

Maribo Health Center, Lolland Municipality

Maribo, Denmark

Guldborgsund Healthcare Center, Guldborgsund Municipality

Nykøbing Falster, Denmark

Vordingborg Healthcare Center, Vordingborg Municipality

Vordingborg, Denmark

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NCT06286722


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