Hip Fractures, Older Adults
Conditions
Brief summary
The primary objective of the proposed research is to investigate the association between protein intake and nutritional status with bone health and physical functioning in older hip fracture patients. In addition, it will be investigated which patient characteristics and modifiable factors can predict mobility, clinical frailty, living situation and mortality. This study will be a 3-month prospective cohort study in adults aged 70 years and older with an acute hip fracture. This study will lead to knowledge about how protein intake and nutritional status in combination with patient characteristics can predict the degree of recovery (bone health and physical functioning) 3 months after the hip fracture. Knowledge on factors related to recovery can contribute to an improved and shorter rehabilitation in the future, which results in a reduction of health care costs.
Detailed description
Only half of the patients with an acute hip fracture regain their pre-fracture functional level and 24% dies within the following year. Identifying and targeting modifiable risk factors for optimal recovery after a hip fracture is therefore essential. These factors include protein intake and nutritional status, which may affect markers of bone health and physical functioning and thereby influence recovery. Measurements will be performed at baseline (within 5 days after the hip surgery) and after 3 months during an outpatient clinic visit for the evaluation of the hip fracture surgery. A total of 95 older adults (aged 70 years or older) recovering from an acute hip fracture will be recruited from Rijnstate hospital.
Interventions
None listed
Sponsors
Rijnstate Hospital
Wageningen University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
70 Years to No maximum
Inclusion criteria
* Age ≥ 70 years * Community-dwelling * Proximal femur fracture: femoral neck fracture/ pertrochanteric fracture, subtrochanteric fracture * Able to give informed consent * Pre-fracture Clinical Frailty Scale 3-6
Exclusion criteria
* Pathological fracture or periprosthetic fracture * Current participation in scientific research that interferes with the proposed study * History of dementia * No permission to request information from the general practitioner/ treating specialist(s) about medical history, medication use, liver and kidney values, and details about the broken hip
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Grip work | Baseline | Using the Martin vigorimeter |
| C-terminal telopeptide of type I collagen | Baseline | Bone turnover marker |
| Calcaneus quantitative ultrasound parameters | Baseline | Ultrasound of the calcaneus which gives an indication of the bone density. Device yields the following two parameters: speed of sound (SOS) and broadband ultrasound attenuation (BUA), which can be combined to get the Stiffness Index (SI). |
| Insulin-like growth factor 1 | Baseline | In serum |
| Parathyroid hormone levels | Baseline | In serum |
| Handgrip strength | Baseline | Using the Martin vigorimeter |
| Protein intake | Baseline | Dietary protein intake will be recorded using a protein screener which gives an indication of protein intake in g/d. Based on the past 4 weeks. |
| Nutritional status | Baseline | Using the Mini Nutritional Assessment Short Form. Subjects will be classified as having a normal nutritional status (12-14 points), having a risk of malnutrition (8-11 points), or being undernourished (0-7 points). |
| Procollagen type 1 N propeptide | Baseline | Bone turnover marker, in serum |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mobility | Baseline | Pre-fracture mobility will be assessed with the pre-fracture mobility scale (PMS). The PMS classifies the patient as independent walker, walk with rollator, in a wheelchair or bedridden. |
| Frailty | Baseline | Frailty will be assessed with the Clinical Frailty Scale. This scale is graded from 1 to 9 in which level 1 represents 'very fit' and level 9 'terminally ill'. |
| Bodyweight | Baseline | Bodyweight (kg) will be measured with a calibrated sitting weighing scale. |
| Barthel Index | Baseline | This questionnaire determines the degree of (physical or verbal) help a person needs to perform general daily activities. It is graded from 0 (person is completely dependent on others) to 20 (person is completely independent). |
| Appendicular skeletal muscle mass | Baseline | Using bioimpedance spectroscopy |
Countries
Netherlands
Outcome results
None listed