A simple screening procedure could identify Indian patients with early cognitive impairment and its implications for the management of geriatric hip fracture

Abstract

Background: Dementia is one of the most common and cognitive impairments growing over the globe. It encompasses a wide range of other neurodegenerative disorders with the symptoms such as loss of memory, inability in carrying out everyday activities, a decline in the brain function activities, and perplexity. However, it has been identified that there is an absolute lack of treatment modalities for dementia, but the early diagnosis plays an important role in identifying the cognitive impairment in the asymptomatic phase itself. It helps in preventing the disease from reaching a further complicated stage. Aim: To assess the impact of cognitive impairment screening on the management of geriatric hip fractures. Methods: It was an observational study carried out at the Shree Krishna Hospital, Karamsad for a period of June, 2018 to May, 2020. Two hundred sixty patients were included in the study. The patients were divided into three groups, namely hemiarthroplasty (HA), Total Hip Arthroplasty (THA), hemiarthroplasty in patients with known dementia (HAd). Result: The study showed male preponderance in the study, and the majority of the patients were above 80 years of age. There was a significant difference in the patients who can perform their grocery or medication independently and not independently with respect to MMSE. However, there was no statistically significant difference in Hip Harris Score. There was a statistically significant difference among the three groups regarding the intraoperative blood, operation duration, hospital stay, ICU postoperative, in-hospital details. Conclusion: In light of the above literature, it was found that hip fractures and cognitive impairment were closely related. There are many risk factors of hip fracture, which are aggravated due to the late diagnosis of cognitive impairment. The incidence of hip fracture among patients suffering from dementia was much higher as compared to normal patients.