Declines in physical functioning attributable to hip fracture among older people: a follow-up study of case-control participants

Purpose : To identify declines in physical functioning, directly attributable to the effects of hip fracture. Methods : A follow-up study of participants in a case-control study was conducted in Auckland, New Zealand, between 1993 and 1996. Nine hundred and eleven randomly selected older people with a hip fracture at the time of the initial interview (cases) and 910 randomly selected older people, without hip fracture (controls), were invited to participate in the study. Two year changes in physical functioning, defined in terms of selfreported mobility, functional dependence and physical activity were examined. Results : Data from the survivors (572 cases and 756 controls) showed that, after controlling for pre-existing chronic medical conditions and disabilities, cases were 4.2 times more likely than controls to be community immobile (95 % confidence interval (CI) 2.8-6.2, p < 0.001) and 2.6 times more likely to be functionally dependent (95% CI 1.7-4.1, p < 0.001). Cases were also spending less hours per day on their feet (2.9) compared with controls (3.5) (F 1,1211 = 55.7, p < 0.001). Conclusions : Hip fractures are associated with dramatic declines in physical functioning at two years, independent of the effects of increasing age, pre-existing medical conditions and disabilities.