Optimized Rehabilitation of Older Adults With Hip Fracture and Signs of Cognitive Impairment - Feasibility Study
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.
- EligibilityCriteria: Inclusion Criteria:  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 Criteria:  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 - HealthyVolunteers: No - Gender: All - MinimumAge: 65 Years - StdAgeList: Older Adult