The relationship between the severity of Alzheimer's disease and recovery of independent mobility after treatment for proximal femoral fracture

Abstract

A case-controlled study of previously mobile female patients with Alzheimer's disease who had sustained a proximal femoral fracture was carried out to determine the influence of the degree of mental impairment on the prospects of regaining independent mobility after treatment. Matched groups of 46 female patients (one group remaining immobile a month after surgery, the other successfully remobilizing) were evaluated for the degree of mental impairment by means of the Blessed Mental Test Score. Patients with severe mental impairment were 17 times (95% confidence interval, 10-27) more likely to remain immobile as compared with those with moderate impairment scores. Two-thirds of the severely impaired had failed to remobilize a month after surgical treatment of their proximal femoral fracture. For patients with severe mental impairment who came from residential care, failure to remobilize was of major importance in precluding return to the same home. Current results of treatment are poor in this group of patients if measured by the return of mobility and the chances of being relocated on leaving hospital.