Dementia linked to higher mortality risk after hip fracture surgery
Risk is higher for people with Parkinson's-related dementia than other types
People with dementia related to Parkinson’s disease are at increased risk of death after undergoing surgery to address broken hips, a new study reports.
Data suggest this increased risk is higher in people with Parkinson’s-related dementia than other types of dementia.
“Our analysis of dementia subtypes reveals that not all dementias confer the same risk … Parkinson disease dementia had a high mortality in the short-term follow-up, underscoring the need for targeted interventions,” researchers wrote in the study “Mortality following hip fracture surgery in patients with dementia: a Swedish multiple national register study,” which was published in European Geriatric Medicine.
In older adults, broken hips can lead to substantial functional limitations and health problems. Previous studies have shown that adults who have dementia (substantial problems with memory and cognition) are more likely to break their hips and have complications following hip surgery. However, it hasn’t been clear whether the risk of poor outcomes is different among people with different subtypes or underlying causes of dementia.
To gain further clarity, scientists conducted an analysis of data from national registries in Sweden. The scientists identified more than 111,000 people 65 or older who underwent hip fracture surgery from 2010 to 2018. Among them, 22% had a documented diagnosis of dementia.
Mortality rate for dementia patients was 13% in first month after surgery
Results in the overall group suggested the risk of death following surgery was notably elevated among people with dementia. In the first month after surgery, the mortality rate for dementia patients was 13%, compared with 6% for non-dementia patients. Similar differences were seen at four months after surgery (27% vs 12%) and one year after surgery (39% vs. 20%).
“Our study found that patients with dementia have a notably higher risk of mortality at 30-day, 4-month, and 1-year post-fracture compared to those without dementia,” the researchers wrote, adding this finding “underscores the necessity of specialized post-operative care for dementia patients.”
When the researchers broke down the results by different types of dementia, they found a substantial increase in risk of death post-surgery for people diagnosed with Parkinson’s disease. Relative to people with other types of dementia, Parkinson’s patients were more than five times as likely to die following surgery. In fact, Parkinson’s-related dementia was the only type of dementia that showed a statistically significant increase in risk of death in the year after surgery compared with people who did not have dementia.
However, after long-term follow up of eight years, this trend was inverted, except for those with dementia with Lewy bodies, a form of atypical parkinsonism.
This finding emphasizes the need to provide additional care after surgery for patients with all forms of dementia, particularly those with Parkinson’s disease who seem to be at highest risk, the researchers wrote. Other studies have suggested outcomes after hip surgery tend to be best for patients who do their recovery in geriatric wards, for example, the researchers noted.
“The high prevalence of dementia among hip fracture patients and its impact on mortality emphasize the need for comprehensive care strategies that address both the cognitive and physical health of these patients,” the scientists wrote.
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