Perceived Health Status Predicts Resilience after Hip Fracture in Older People

Medicina (Kaunas). 2024 Oct 3;60(10):1621. doi: 10.3390/medicina60101621.

Abstract

Background and Objectives: Perceived health status (PHS) is associated with various health outcomes in older adults, but its relationship with resilience in the context of events with a major impact on functional status (FS), such as hip fracture, has not been explored. Our objective was to evaluate whether older adults who report good PHS before a hip fracture have a higher probability of returning to their baseline physical performance (PP) and personal independence. Materials and Methods: We analyzed data from waves 1 and 2 of the Survey of Health, Ageing and Retirement in Europe (SHARE) study, enrolling patients ≥ 65 years who experienced a hip fracture between these two waves. As study outcomes, we analyzed changes in PP and functional abilities (FAs). Results: We included 149 participants with a mean age of 75.7 years (SD: 6.5); women comprised 66%. The incidence of loss of PP was 51.7% among participants with good PHS and 59.6% among those with poor PHS. FA worsened in 40% of participants with good PHS and 58.4% in those with poor PHS. Relative risk (RR) for loss of FA in people with good PHS was 0.68 (95% CI: 0.48-0.98), which did not change after an adjustment for age, gender, baseline FA, depression, number of comorbidities, education, income, and social support, despite it not reaching statistical significance. After adjustment, the risk of worsening PP in participants with good PHS was reduced by 34% (95% CI: 0.41-1.06). Conclusions: A simple question on PHS may predict the resilience of older adults after an acute stressor. A systematic evaluation of PHS can help identify patients with a higher probability of regaining function after a hip fracture and thus provide useful information for resource allocation.

Keywords: hip fracture; older; perceived health status; rehabilitation; resilience.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Europe / epidemiology
  • Female
  • Health Status*
  • Hip Fractures* / psychology
  • Humans
  • Male
  • Perception
  • Resilience, Psychological*

Grants and funding

The SHARE data collection has been funded by the European Commission through the 5th framework program (project QLK6-CT-2001-00360 in the thematic program Quality of Life). Further support by the European Commission through the 6th framework program (projects SHARE-I3, RII-CT-2006-062193, as an Integrated Infrastructure Initiative, COMPARE, CIT5-CT-2005-028857, as a project in Priority 7, Citizens and Governance in a Knowledge Based Society, and SHARE-LIFE (CIT4-CT-2006-028812)), through the 7th framework program (SHARE-PREP (No 211909), SHARE-LEAP (No 227822), M4 (No 261982), and DASISH (No 283646), through Horizon 2020 (SHAREDEV3 (No 676536), SERISS (No 654221), SSHOC (No 823782), SHARE-COHESION (No 870628), SHARE-COVID19 (No 101015924), RItrain (No 654156) and ERIC Forum (No 823798)) and by DG Employment, Social Affairs & Inclusion through VS 2015/0195, VS 2016/0135, VS 2018/0285, VS 2019/0332, VS 2020/0313, SHARE-EUCOV: GA No 101052589 and EUCOVII: GA No 101102412 is gratefully acknowledged. Co-funding was granted by the US National Institute on Aging (U01 AG09740-13S2, P01 AG005842, P01 AG08291, P30 AG12815, R21 AG025169, Y1-AG-4553-01, IAG BSR06-11, OGHA 04-064, BSR12-04 and R01AG052527-02); further funding was granted for the development of a Harmonized Cognitive Assessment Protocol (HCAP) (R01 AG056329-02). Substantial funding for the central coordination of SHARE was received from the German Federal Ministry for Education and Research (Bundesministerium für Bildung und Forschung, BMBF) and the Max Planck Society for the Advancement of Science.