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Cognitive plasticity as a moderator of functional dependency in elderly patients hospitalized for bone fractures

Kognitive Plastizität als Einflussfaktor funktioneller Abhängigkeit bei Älteren mit Knochenbrüchen im Krankenhaus

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Abstract

Introduction

Bone fractures in older adults involve hospitalization and surgical intervention, aspects that have been related to loss of autonomy and independence. Several variables have been studied as moderators of how these patients recover. However, the implications of cognitive plasticity for functional recovery have not been studied to date.

Objective

The present study analyzes the relationship between cognitive plasticity—defined as the capacity for learning or improved performance under conditions of training or performance optimization—and functional recovery in older adults hospitalized following a bone fracture.

Patients and methods

The study comprised 165 older adults who underwent surgery for bone fractures at a hospital in southern Spain. Participants were evaluated at different time points thereafter, with instruments that measure activities of daily life (ADL), namely the Barthel Index (BI) and the Lawton Index, as well as with a learning potential (cognitive plasticity) assessment test (Auditory Verbal Learning Test of Learning Potential, AVLT-LP).

Results

Results show that most of the participants have improved their level of independence 3 months after the intervention. However, some patients continue to have medium to high levels of dependency and this dependency is related to cognitive plasticity.

Conclusion

The results of this study reveal the importance of the cognitive plasticity variable for evaluating older adults hospitalized for a fracture. They indicate a possible benefit to be obtained by implementing programs that reduce the degree of long-term dependency or decrease the likelihood of it arising.

Zusammenfassung

Einführung

Knochenbrüche bei älteren Menschen bedeuten einen Krankenhausaufenthalt und chirurgische Intervention. Das sind Faktoren, die mit dem Verlust der Autonomie und der Unabhängigkeit in Zusammenhang stehen. Bisher wurden verschiedene Variablen als Einflussfaktoren auf die Heilung untersucht. Bisher nicht untersucht wurden Auswirkungen der kognitiven Plastizität auf die funktionelle Genesung.

Ziel

Die vorliegende Studie analysiert die Beziehung zwischen kognitiver Plastizität, definiert als Lernfähigkeit oder als Leistungssteigerung bei Training- oder Leistungsoptimierung, und funktioneller Genesung bei älteren Menschen im Krankenhaus nach Knochenfraktur.

Patienten und Methoden

In diese Studie wurden 165 ältere Patienten mit Knochenbrüchen eingeschlossen, die sich in einem Krankenhaus in Südspanien einer Operation unterzogen. Anschließend wurden zu verschiedenen Zeitpunkten tägliche Aktivitäten (ADL) mit dem Barthel-Index und dem Lawton-Index gemessen und ein Test zur Beurteilung der kognitiven Plastizität (Auditory Verbal Learning Test of Learning Potential, AVLT-LP) durchgeführt.

Ergebnisse

Die Ergebnisse zeigen, dass 3 Monate nach dem Eingriff eine Verbesserung der Unabhängigkeit bei den meisten Teilnehmern eintrat. Bei einigen jedoch bestand auch nach dieser Zeit weiterhin eine mittlere bis hohe Abhängigkeit, was im Zusammenhang mit der kognitiven Plastizität der Teilnehmer zu werten ist.

Schlussfolgerung

Die Ergebnisse dieser Studie zeigen die Bedeutung der Variable kognitive Plastizität für die Bewertung älterer Menschen, die mit einem Knochenbruch im Krankenhaus sind. Des Weiteren deuten sie auf einen möglichen Nutzen von Programmen hin, die den Grad einer langfristigen Abhängigkeit bzw. die Wahrscheinlichkeit, dass diese entsteht, verringern.

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Compliance with ethical guidelines

Conflict of interest. M.J. Calero-García, M.D. Calero, E. Navarro and A.R.Ortega state that there are no conflicts of interest. All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients included in studies.

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Authors and Affiliations

  1. Faculty of Health Sciences, University of Jaén, Campus Lagunillas, 23071, Jaén, Spain

    M.J. Calero-García Ph.D.

  2. Faculty of Psychology, University of Granada, Granada, Spain

    M.D. Calero & E. Navarro

  3. Department of Psychology, University of Jaén, Jaén, Spain

    A.R. Ortega

Authors
  1. M.J. Calero-García Ph.D.
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  2. M.D. Calero
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Correspondence to M.J. Calero-García Ph.D..

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Calero-García, M., Calero, M., Navarro, E. et al. Cognitive plasticity as a moderator of functional dependency in elderly patients hospitalized for bone fractures. Z Gerontol Geriat 48, 22–28 (2015). https://doi.org/10.1007/s00391-014-0610-4

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