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Trajectories of nutritional status and cognitive impairment among older Taiwanese with hip fracture

The journal of nutrition, health & aging volume 21, pages 38–45 (2017)Cite this article

Abstract

Objective

This paper describes the trajectories of nutritional status and cognitive impairment and their correlation among older Taiwanese over 1 year after hip-fracture surgery.

Design

Secondary analysis of data from a clinical trial evaluating the effects of three types of post-discharge care for 292 older hip-fracture patients (age >60 years).

Measurements

Nutritional status was assessed by the Mini Nutritional Assessment before and 1, 3, 6, 12 months after hospital discharge. Cognitive function was measured by the Mini-Mental State Examination before surgery, at hospital discharge, 6 and 12 months after discharge. Trajectories of nutritional status and cognitive impairment were depicted by latent class growth modeling, whereas linkages between nutritional-status and cognitive-impairment trajectories were assessed by multinomial logistic regression.

Results

Nutritional status in general improved significantly, particularly during the first 3 months after discharge. We identified three trajectories of nutritional status: malnourished (15.4%), at risk for malnutrition (38.9%), and well-nourished (45.7%). In contrast, cognitive changes followed four largely linear but distinct trajectories: moderately impaired (12.2%), mildly impaired (27.8%), borderline impaired (21.8%), and cognitively intact (38.2%). Trajectories of nutritional status were significantly associated with cognitive-function trajectories. For instance, relative to malnourished patients, well-nourished patients were 95% less likely (OR=0.05, CI =0.01-0.24) to be moderately cognitively impaired.

Conclusion

A good nutritional-status trajectory after hip fracture was associated with better cognitive function. To treat and care for elderly hip-fractured patients, specific interventions need to target those who are malnourished or at risk of malnutrition to decrease their risk for cognitive impairment.

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Author information

Affiliations

  1. Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan

    H. P. Wang

  2. School of Nursing, Hsin Sheng College of Medical Care and Management, Taoyuan, Taiwan

    H. P. Wang

  3. School of Public Health and Institute of Gerontology, University of Michigan, Ann Arbor, Michigan, USA

    J. Liang

  4. School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan

    L. M. Kuo

  5. Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan

    C. Y. Chen

  6. School of Nursing, College of Medicine, Chang Gung University, 259 Wenhua 1st Road, Guishan District, Taoyuan, 33302, Taiwan

    Yea-Ing L. Shyu

  7. Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan

    Yea-Ing L. Shyu

  8. Traumatological Division, Department of Orthopedics, Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Yea-Ing L. Shyu

Authors
  1. H. P. Wang
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  2. J. Liang
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  3. L. M. Kuo
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  4. C. Y. Chen
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  5. Yea-Ing L. Shyu
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Correspondence to Yea-Ing L. Shyu.

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Wang, H.P., Liang, J., Kuo, L.M. et al. Trajectories of nutritional status and cognitive impairment among older Taiwanese with hip fracture. J Nutr Health Aging 21, 38–45 (2017). https://doi.org/10.1007/s12603-016-0756-4

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  • DOI: https://doi.org/10.1007/s12603-016-0756-4

Key words

  • Cognitive function
  • nutritional status
  • trajectory group
  • hip fracture