TY  - EJOU
AU  - Laksono, Tri 
AU  - Chen, Yu-Pin 
AU  - Chen, Yi-Jung 
AU  - Yap, Kah-Ying 
AU  - Hu, Fang-Wen 
AU  - Huang, Chi Hsien 
AU  - Wu, Lien-Chen 
AU  - Kuo, Yi-Jie 
AU  - Griffiths, Mark D. 
AU  - Lin, Chung-Ying 

TI  - Trajectories of Functional Ability and Quality of Life among Older Adults after Hip Fracture with and without Cognition Impairment: A Three-Month Longitudinal Study
T2  - International Journal of Mental Health Promotion

PY  - 
VL  - 
IS  - 
SN  - 2049-8543

AB  - <b>Background</b>: Hip fractures among older adults lead to significant morbidity and mortality, often complicated by pre-existing cognitive impairment. Understanding the longitudinal trajectories of functional ability and quality of life (QoL) among this specific population is crucial for customized interventions development. The present study compared the three-month trajectories of functional ability and QoL among older adults after hip fracture, specifically differentiating between those with and without cognitive impairment. <b>Methods</b>: A three-month longitudinal comparison analysis was conducted with 647 older adults following hip fracture. Participants were stratified by cognitive status (intact [n = 377] vs. impaired [n = 270]). Repeated measures analysis of variance (RM-ANOVA) and generalized estimating equations (GEEs) were employed to compare the trajectories of the functional ability, functional mobility and QoL utility score. <b>Results</b>: RM-ANOVA showed significant changes over time for functional ability, functional mobility, and QoL. A significant interaction between time and cognitive status was found for functional ability (<i>p</i> &lt; 0.001, ω<sup>2</sup> = 0.011) and functional mobility (<i>p</i> &lt; 0.001, ω<sup>2</sup> = 0.013), suggesting differing recovery patterns based on cognitive status. GEE analyses confirmed that the cognition-intact group experienced a notable deterioration in QoL over time. However, the pace of QoL decrease was not statistically different between the two groups. Moreover, the group with cognitive impairment showed a significantly faster decline in both functional ability and mobility (<i>p</i> &lt; 0.001) over three-month follow-up. <b>Conclusions</b>: Cognitive impairment among older adults after hip fracture is associated with a significantly poorer baseline condition and, critically, an accelerated decline in functional ability and mobility over the initial three-month recovery period. These findings underscore the need for early identification and tailored support strategies for cognitively impaired individuals to mitigate functional decline and improve post-fracture outcomes.
KW  - Hip fracture; older adults; cognition; quality of life; functional recovery; EQ-5D-3L; Barthel Index

DO  - 10.32604/ijmhp.2026.082706