The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Advance Access published online on February 19, 2009
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, doi:10.1093/gerona/glp002
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Methodology and Baseline Characteristics for the Sarcopenia and Hip Fracture Study: A 5-Year Prospective Study
1 Exercise, Health and Performance Faculty Research Group, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia
2 Hebrew SeniorLife, Boston, Massachusetts
3 Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
4 Balmain Hospital, New South Wales, Australia
5 Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
6 Gastrointestinal Investigation Unit and Centre for In Vivo Body Composition
7 Department of Aged Care & Rehabilitation Medicine, Royal North Shore Hospital, St. Leonards, New South Wales, Australia
8 Centre for Experimental Radiation Oncology, Cancer Care Centre, St. George Hospital, Kogarah, New South Wales, Australia
9 St. George Hospital, Kogarah, New South Wales, Australia
10 Faculty of Medicine, University of New South Wales, Sydney, Australia
11 Present address: Australian Clinical Trials Registry, NHMRC Clinical Trials Centre Level 5, Camperdown, New South Wales, Australia
Address correspondence to Maria A. Fiatarone Singh, MD, Exercise, Health and Performance Faculty Research Group, Faculty of Health Sciences, University of Sydney, East Street, Lidcombe 2141, New South Wales, Australia. Email: m.singh{at}usyd.edu.au
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Abstract |
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Background: Age-related hip fractures are associated with poor functional outcomes, resulting in substantial personal and societal burden. There is a need to better identify reversible etiologic predictors of suboptimal functional recovery in this group.
Methods: The Sarcopenia and Hip Fracture (SHIP) study was a 5-year prospective cohort study following community-dwelling older persons admitted to three Sydney hospitals for hip fracture. Information was collected at baseline, and 4 and 12 months, including health status, quality of life, nutritional status, body composition, muscle strength, range of motion, gait velocity, balance, walking endurance, disability, cognition, depression, fear of falling, self-efficacy, social support, physical activity level, vision, and fall-related data, with residential status, disability, and mortality reassessed at 5 years.
Results: 193 participants enrolled (81 ± 8 years, 72% women). High levels of activities of daily living, disability and sedentariness were present prior to fracture. At admission, the cohort had high levels of chronic disease; 38% were depressed, 38% were cognitively impaired, and 26% had heart disease. Seventy-one percent of participants were sarcopenic, 58% undernourished, and 55% vitamin D deficient. Mobility, strength, and vision were severely impaired. There was little evidence that these comorbidities were either recognized or treated during hospitalization. Disability, sedentariness, malnutrition, and walking endurance predicted acute hospitalization length of stay.
Conclusions: The complex comorbidity, pre-existing functional impairment, and sedentary behavior in patients with hip fracture suggest the need for thorough screening and targeting of potentially reversible impairments. Rehabilitation outcomes are likely to be highly dependent on amelioration of these highly prevalent accompaniments to hip fracture.
Keywords Body composition; Disability; Hip fracture; Sarcopenia
Received: June 8, 2008; Accepted: November 17, 2008