Dementia patients admitted to acute hospital settings with a hip fracture. Mental and Behavioural Disorders
Conditions
Interventions
Participants due to have a hip fracture operation via spinal anaesthesia with all levels of pre-operative confusion (as assessed by clinical screening procedures, AMTS (England) and 4AT (Scotland)) wi
Sponsors
University of East Anglia
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Group 1: Pre-operative acute hip fracture patients with confusion as defined by the Abbreviated Mental Test (England) or 4AT (Scotland): Inclusion Criteria: 1. Patient must have had a confirmed proximal hip fracture requiring an operation and be aged 60 or older at the time of operation 2. Patient has a pre-operative Abbreviated Mental Test score of 8 or below or 4AT score of 1 or above 3. Patient must be undergoing spinal anaesthesia Group 2: Pre-operative acute hip fracture patients without confusion as defined by the Abbreviated Mental Test (England) or 4AT (Scotland): Inclusion Criteria: 1. Patient must have had a confirmed proximal hip fracture requiring an operation and be aged 60 or older at the time of operation 2. Pre-operative Abbreviated Mental Test score of 9 or above or 4AT score of 0 3. Patient must be undergoing spinal anaesthesia
Exclusion criteria
Exclusion criteria: Group 1 and 2: 1. Decision taken not to have hip surgery 2. Patient has head trauma with bleeding as indicated by a CT scan 3. Patient has confirmed diagnosis of Parkinson’s disease 4. Patient not expected to survive beyond 4 weeks
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| CSF inflammation and injury is measured by TNF-a, IL-1RA, IL-1ß, IL-6 and Neurogranin, tTau, Synaptotagmin, SNAP-25 at baseline. | — |
Secondary
| Measure | Time frame |
|---|---|
| Magnitude of the brain inflammation is measured by brain injury markers (phospho-Tau, NFL, neurogranin, synaptotagmin, SNAP-25) in CSF at baseline. Exploratory: 1. Higher levels of inflammatory and brain injury markers in CSF and blood are associated with worsening cognitive and functional decline measured by MMSE at 6 months post-operatively 2. Cytokines ratio CSF:blood pre-op time will show higher ratios in dementia than non-dementia patients measures in blood and CSF at baseline | — |
Countries
England, Scotland, United Kingdom
Contacts
Public ContactSimon Hammond
Outcome results
None listed