Rehabilitation after hip fracture in patients with dementia

Rehabilitation after hip fracture in patients with dementia

  1. 1. J Am Geriatr Soc. 2007 Aug;55(8):1309-10. Rehabilitation after hip fracture in patients with dementia. Giusti A, Barone A, Pioli G. PMID
  2. People with dementia who receive enhanced care and rehabilitation in hospital after a hip fracture may be less likely to develop delirium. When care is led by a geriatrician, they may have stays in hospital that are three to four days shorter than if care is led by an orthopaedic surgeon
  3. Journal of the American Geriatrics Society. Volume 55, Issue 8 p. 1309-1310 p. 1309-131
Number of summarized nutrition intervention trials [eitherElderly people may never recover from hip fracture: study

Rehabilitation for people with dementia following a hip

Of 11,200 individuals with dementia who experienced a hip fracture during the study period, 4,494 (40.1%) received no rehabilitation, 2,474 (22.1%) were admitted to CCC, 1,157 (10.3%) received HCR, and 3,075 (27.4%) received IPR. HCR and IPR were associated with less risk of LTC admission after discharge from hospital than no rehabilitation Recovery following a hip fracture tends to be particularly challenging for patients with cognitive impairment36). Approximately 19% of all elderly individuals with hip fractures have dementia, and up to 40% of them with a hip fracture have some form of cognitive impairment (e.g., dementia, delirium, mild cognitive impairment)37) If delirium develops, it can lead to longer hospitalizations, poorer recovery in terms of mobility and longer facility care. 3  The recovery and rehabilitation of someone with dementia after a hip fracture can be complicated by memory loss

Background Hip fractures are common in patients with advanced dementia, and many experts advocate that they be considered a sentinel 'palliative' event due to their strong association with reductions in quality of life and 1-year survival.Management decisions are often complicated due to the need for quick decisions by surrogates, involving multiple surgical and non-surgical options, often. Nursing home residents sustaining a hip fracture have poor outcomes both in terms of survival and ambulation. Using US Medicare data on nursing home residents from 2005 through 2009, Neuman and colleagues 1 found that by 6 months after the fracture, 36.2% had died; moreover, among residents who were not totally dependent in prefracture locomotion, 54% had either died or developed new total. provide best care for hip fracture patients. 2 These patients frequently have concomitant medical conditions including dementia that increase the complexity of care that is required. As the majority of hip fractures occur as a result of a simple fall from a allow patients to attain maximal recovery following hip fracture

MORTALITY AFTER GERIATRIC HIP FRACTURE •7% at 1 month •13% at 3 months •24% at 12 months •50% at 6 months for patients with end-stage dementia •Fracture is marker of frailty •Mortality increases with: Uncontrolled systemic disease Multiple comorbidities Dementia Lu Slide 3 -Yao, et al. Am J Pub Health. 1994;84:1287 1291 Purpose: Best rehabilitation practices after hip fracture for people with dementia have not been established. A systematic review was conducted to determine current evidence for rehabilitation in..

Severe dementia is a life-limiting condition; hip fractures are more common in patients who have dementia. This study outlines the case of a 92-year-old female with severe dementia who sustained a hip fracture. Despite having a terminal diagnosis (severe dementia and hip fracture) and poor premorbid quality of life, she had a life-prolonging. The aim is to investigate the relationship between a positive outcome of rehabilitation after hip fracture and behavioral psychological symptoms of dementia (BPSD) transition during rehabilitation. We researched whether improvement of BPSD might lead to a beneficial outcome of rehabilitation for older people with hip fracture Conclusions: People with mild or moderate dementia may show improved function and ambulation and decreased fall risk after rehabilitation post hip fracture, similar to gains achieved by those without dementia. More research is required to ascertain the effect of rehabilitation in people with moderate to severe dementia, including those residing.

Rehabilitation After Hip Fracture in Patients With Dementi

Hip fractures are associated with increase in all-cause mortality with an overall mortality of 13% at three months and 23% at 12 months (8). Among nursing home residents with advanced dementia and hip fracture, 35% died within 6 months and 62% died within 2 years of the fracture (9). Risk factors for increased mortality after a hip fracture. O UTCO M ES RESEA RCH I N REV I EW Reha bilita tion After Hip Fra cture in Pa tients w ith Dementia Huusko TM, Karppi P, Avikainen V, et al. Randomised, clinically controlled trial of intensive geriatric rehabilitation in patients with hip fracture: subgroup analysis of patients with dementia. BMJ 2000;321:1107-11 Rehabilitation for people with dementia after hip fracture is complex. Approximately 40% of patients who sustain a hip fracture have dementia [85, 86]. These patients have more complex care needs, with greater risks of complications, physical disabilities and social care requirements compared to people without dementia . This is due to a number.

If your loved one has dementia and been through a hip operation, you should always start therapy as soon as possible. My mom has dementia and just had a hip operation, and the surgeon suggests to mobilize her as soon as possible. Hospital staff will not do much with the patient Bellelli, G, Frisoni, GB, Turco, R, Trabucchi, M. Depressive symptoms combined with dementia affect 12-months survival in elderly patients after rehabilitation post-hip fracture surgery. Int J Geriatr Psychiatry. 2008;23(10): 1073 - 1077. Google Scholar | Crossref | Medline | IS Method: All patients (age ≥65 years) who had been operated on for a hip fracture in the Copenhagen University Hospital region in 2009 were included. Data about analgesic use for the first 72 h after surgery were acquired from the hospitals' electronic medication system and linked with information about dementia, comorbidity, and prior drug use Instead, Oh hopes to alert patients, doctors and caregivers to one risk in particular faced by those undergoing surgery to repair a hip fracture after a fall: postoperative delirium, a severe state of confusion that can hinder rehabilitation efforts while causing lasting effects on the brain — and which patients with Alzheimer's are more likely to experience Hip fracture in elderly patients is a global public health concern because of its frequency and functional consequences on individuals experiencing this event [1,2,3].Population ageing and increasing frailty play an important role in delayed recovery and declining health in this group of patients [].Moreover, long-term morbidity related to poor management of hip fracture is associated with.

Orthopedic Rehabilitation

Rehabilitation of Older Adults with Dementia After Hip

Abstract and Figures Background/aims: Prior studies have shown that patients with dementia are at risk of receiving insufficient treatment for pain after a hip fracture. We therefore hypothesized.. They noted, however, that patients with dementia have often been excluded from larger outcome studies of hip fracture rehabilitation. Patients in this study had a median 21-day inpatient stay after admission for their hip fracture, so much of the rehabilitation included as inpatient care in the Japanese schema would be delivered in the. Elderly patients with hip fracture and no sign of cognitive decline almost all showed markers for Alzheimer's disease in a recent study. The researchers say hip injury from a fall may be an. Dementia is one of the most important risk factors for delirium in the elderly and its prevalence is increasing. 23 The effects of dementia on the outcome after delirium (delirium superimposed on dementia) have been rarely described and, to the best of our knowledge, never in elderly hip fracture patients. 24,2 Conclusions and Implications. This study showed that age, PFMS, premorbid Katz-ADL, surgical treatment, ASA score, type of anesthesia, history of dementia, and cotreatment by a geriatrician were independent early predictors for discharge to geriatric rehabilitation vs discharge home in older patients after hip fracture surgery

Postoperative Rehabilitation after Hip Fracture: A

Post-acute care may improve dementia patients' prognoses. Those with dementia who lived in their communities were more likely to die after a hip fracture, according to the article. But that may be because they're not subject to the same professional (and rigorous) rehab programs that care centers offer Patients were eligible to participate if they were: (a) 65 years or older; (b) with or without CI; (c) admitted to rehabilitation directly from acute care after receiving surgery for hip fracture; (d) living at home prior to the hip fracture (i.e., living in a family home or retirement home); and (e) had a family member or close friend who. this is particularly evident amongst patients presenting with a hip fracture. Of the approximately 80,000 patients admitted to hospital with hip fracture in the UK every year4 in excess of a quarter are likely to be dementia sufferers5. The risk of suffering a hip fracture has been shown to be three times higher for thos

Hip fractures are nearly always repaired surgically unless there are very strong medical reasons for not doing so. Dementia of itself is not usually a sufficient cause to prevent surgery, even though the adverse effects of general anaesthesia and problematic post-surgical care (such as the patient being unco-operative with physio therapy) are. Cognitive impairment such as dementia is a common Immobility after a hip fracture can lead to poor patient outcomes. Even if the patient has not had surgery, rehabilitation is necessary to.

We found hip fracture patients with severe dementia received surgery with a greater likelihood and with a shorter waiting time compared to patients without dementia or with only mild dementia. With regard to age, very old patients in their 80s and 90s are less likely to receive surgery compared to patients between the ages of 65 and 79 Aim: Hip fracture implies severe problems to older people; special concerns regard persons with dementia, due either to cognitive impairment, or to behavioral and psychic symptoms. This study illustrates rehabilitative outcomes of these patients discharged by a special care unit ruled by GentleCare principles. Method: 54 patients [89% females, aged 82.3 years (range 66 - 94)] followed a.

The Dangers of Hip Fractures in Dementi

Hip fractures in the older population remain an important cause of morbidity and mortality. Surgical management has resulted in superior outcomes for most patients. The study found that patients with dementia had improved mortality with surgical repair of hip fracture, as well as improved pain and lower rates of pressure ulcers Patients with dementia who undergo hip replacement surgery have problems complying with postoperative instructions, taking medications and cooperating with therapists. This puts them at increased risk for complications during and after surgery, reoccurrence of the fracture and difficulties recovering. While it can be challenging for caregivers. Results Fracture risk calculation. Parkinson's disease patients have a 2.2-fold increased risk of all fractures and a 3 to 4 times increased risk of hip fracture. 7-10 Yiannopoulou et al. 4 compared hip fracture patients with age-matched controls and found both groups had sizable proportions of previously undiagnosed Parkinsonism (91.8 and 86.7% respectively, P = 0.471) Background: Hip fractures (HF) are frequent in older adults. A substantial number of cognitively impaired patients are admitted to rehabilitation unit.

Patients with prior hip fractures have an increased risk of future fragility fracture, including an almost 9% chance of fracturing the second hip within 2 years, 1 emphasizing the importance of osteoporosis and fall prevention care, particularly after a hip fracture has already occurred. Major risk factors for fragility fracture in this patient. X-rays will be taken at six weeks after surgery to make sure the fracture is healing and further accelerate rehabilitation. While the goal is to return geriatric hip fracture patients to the level of function they had before their injury, this can be challenging for some in this senior patient population The chances of recovery among hip-fracture patients older than 85 with dementia or other health problems are even lower, the study authors found. By being able to set realistic expectations of. One longitudinal study involving 231 hip fracture patients also found that patients with cognitive impairment could not retain rehabilitation gains in locomotion, transfers, self-care, and sphincter control 1 yr after discharge, although they experienced recovery at 2 and 6 mos. 27 Both neurological disorders 28 and orthopedic diseases 29,30.

We investigated the association between FNB performed in the operating room and the recovery of physical function after hip fracture surgery, including patients with dementia. Methods A total of 103 patients with a mean age of 87.4 years who underwent hip fracture surgery under spinal anesthesia between July 2015 and December 2017 (46 patients. Background Hip fracture is a major fall-related injury which causes significant problems for individuals, their family and carers. Over 40% of people with hip fracture have dementia or cognitive impairment, and their outcomes after surgery are poorer than those without dementia

Decision Making for Patients with Advanced Dementia and a

  1. Patients with cognitive impairment admitted to orthopedic/orthogeriatric wards after hip fracture present complications that require additional skills from healthcare teams, for example, considering the consequent reduced mobility after hip fracture. A patient with dementia who likes to walk as a means of interacting with their environment may.
  2. Background: People with dementia are a high-risk group for hip fractures. Although the increased risk of hip fractures associated with antipsychotic drugs (APD) is found in older populations, little is known about the risk for people with dementia living in Asia. We aimed to investigate the association between hip fractures and the characteristics of APD use in patients with dementia
  3. Objectives To assess whether the association of depression and dementia affects 12‐month survival of elderly patients after rehabilitation post‐hip fracture (HF) surgery. Methods Two hundred eleve..
  4. The patients' outcome data came from their medical records. The main outcome measure was the length of active rehabilitation including physical therapy after surgery. Results and Conclusions: In this study the most common surgical method to treat hip fracture was osteosynthesis (55%). Most patients having osteosynthesis were recommended by a.
  5. Rehabilitation in hospital. A physiotherapy assessment and mobilisation, such as weight-bearing exercises, should begin the day after hip fracture surgery. While you're in hospital, your rehabilitation may take place in: an orthopaedic ward - for people with bone and joint condition
  6. Hip fractures are common in older patients, with a lifetime estimated risk of 6% for men and 18% for women. ( 1) A 50-year-old woman has a 2.8% lifetime risk of death from a hip fracture, which is equivalent to the lifetime risk of death from breast cancer. ( 2) Patients with hip fracture are often frail and medically complex, and they require.
  7. Data shows that incidence of hip fractures increases from 22.5 per 100,000 at age 50 to 630 per 100,000 for men, and from 23.9 in 100,000 at age 50 to 1289per 100,000 by age of 80 for men and women. In 2010, there were 258,000 hospital admissions for hip fractures in people aged 65 and older and three quarters of hip fractures occurred in women

Participants: All individuals with hip fractures who underwent hip fracture surgery in Ontario, Canada between April 1, 2003 and March 31, 2010 were identified. Physician-diagnosed dementia, prior to hip fracture, was identified using a diagnostic algorithm in the administrative databases All patients (age ≥65 years) who had been operated on for a hip fracture in the Copenhagen University Hospital region in 2009 were included. Data about analgesic use for the first 72 h after surgery were acquired from the hospitals' electronic medication system and linked with information about dementia, comorbidity, and prior drug use

Commonly, patients with osteoporosis are not treated prior to or after sustaining a hip fracture. 6 In addition to those with osteoporosis, certain other populations are at increased risk of sustaining hip fractures including those with dementia and those with a history of prior fragility fractures. 5,7,[8][9][10] Hip fractures and dementia are. For older adults, the odds of suffering a hip fracture increase as bones tend to weaken. The U.S. Centers for Disease Control and Prevention reports that more than 300,000 people aged 65 and older. In a prospective study of 106 elderly hip fracture patients without prefracture dementia, Krogseth et al 25 found that of 29 patients who experienced delirium, 11 (37%) fulfilled the criteria of dementia after 6 months, compared with 5/77 (7%) without delirium (P < 0.001), and further found that delirium was a strong predictor of dementia after. We investigated the association between FNB performed in the operating room and the recovery of physical function after hip fracture surgery, including patients with dementia. METHODS: A total of 103 patients with a mean age of 87.4 years who underwent hip fracture surgery under spinal anesthesia between July 2015 and December 2017 (46 patients. Recovery following a hip fracture tends to be particularly challenging for patients with cognitive impairment 36). Approximately 19% of all elderly individuals with hip fractures have dementia, and up to 40% of them with a hip fracture have some form of cognitive impairment (e.g., dementia, delirium, mild cognitive impairment) 37)

Hip Fractures in Patients With Advanced Dementia: What

  1. Although literature about mortality, morbidity, and prognostic factors for rehabilitation after hip fracture is abundant, few studies report health-related quality of life 6,8,30 or give a detailed account of the type of residence in which the patient is living and the accompanying costs of treatment and living arrangements. 7,15,20,33 To provide a full description of the consequences of hip.
  2. Introduction. The number of demented patients with hip fracture is increasing as the population ages. In Finland, the prevalence of moderate to severe dementia in people aged 65 years and over is 6.7 per 1000. 1 Alzheimer-type dementia has been reported to increase the risk of hip fractures, with an odds ratio of 6.9. 2 Dementia was the main contributor to the development of functional.
  3. Hip fracture can have serious consequences, with a mortality rate of 10% at one month after a fall, 20% at four months and 30% at one year (Parker and Johansen, 2006). The average age for this group of patients who fall and fracture their neck of femur is over 80 and 75% of these are female
  4. Osteoporotic fractures are common among older people, and hip fractures (HF) can be devastating. Surgery is indicated for most cases of HF, and chronic persistent postoperative pain is likely to occur. This study investigated the multifaceted factors related to persistent pain occurring during the acute phase and subacute phase of recovery after HF surgery. We conducted a prospective 8-week.


Rehabilitation in Patients with Dementia Following Hip

Patients with hip fracture are susceptible to foreseeable and potentially avoidable complications. An interprofessional team approach to care that uses evidence-based strategies for prevention, early detection, and proactive care to avoid complications are the key to optimal patient outcomes Patients with hip fractures are at high risk for future fractures including hip, wrist, shoulder, and spine. After treatment of the acute fracture, the risk of future fractures should be addressed. Currently, only 1 in 4 patients after a hip fracture receives treatment and work up for osteoporosis, the underlying cause of most of the fractures This study analyzes recovery, incidence of delirium and 30-day mortality, after hip surgery. Results and discussion. Patients with dementia make poor functional recoveries after hip fracture as compared to nondemented patients. Individuals with dementia use rehabilitation less after hip fracture surgery

Hip fractures and dementia: clinical decisions for the

  1. hip fracture.[13] Recovery following hip fracture can be aided by access to, and participation in, rehabilitation-related activities.[14] In particular, early and regular weight-bearing activities, where a patient's condition allows, has been shown to benefit recovery to pre-fracture ambu-latory ability. The presence of dementia has bee
  2. A scholarly article on my mother's recovery was published in the Annals of Long-term Care. The reference is: Hip Fracture Rehabilitation in Persons with Dementia: How Much Should We Invest? Elliot Davis, PhD, James Biddison, and Jiska Cohen-Mansfield, PhD Annals of Long-Term Care - ISSN: 1524-7929 - Volume 15 - Issue 3 - March 2007 - Pages: 19 - 2
  3. Rehabilitation After Hip Fracture In Patients With Dementia - Discover The . close. Home; Rehabilitation After Hip Fracture In Patients With Dementia. Tweet. Always take the stairs rather than elevator. Something as simple as inverting your bed while sleeping can also make you taller quickly. It's best if you simply stick to heels less than.
  4. adults after hip fracture. B Clinicians should provide physical therapy/rehabilitation to patients with mild to moderate dementia, using similar interventions and prescriptions as for those without dementia. EARLY POSTOPERATIVE PERIOD: INPATIENT SETTING Interprofessional Rehabilitation Program

2006). The several inpatient rehabilitation options after hip fracture surgery include rehabilitation beds in acute-care hospitals or free-standing rehabilitation hospitals, specialized geriatric units, higher level sub-acute long-stay beds, and convalescent care beds. In the United States for example, hip fracture patients with CI are admitted t Following hip fracture and subsequent surgery, many older people suffer a decline in mobility, independence and quality of life. Social and psychological factors such as fear of falling, self-efficacy, perceived control and coping strategies are now thought to be important in the recovery from hip fracture

Strong evidence supports use of an interdisciplinary care program in those patients with mild to moderate dementia who have sustained a hip fracture to improve functional outcomes. Strength of Recommendation: Strong. Description: Evidence from two or more High strength studies with consistent findings fo side. Fifteen of the 30 had dementia, and 25 had hip or knee contractures (Fig 1). Twenty-three patients had closed supracondylar fractures of the femur. Among these, 19 had an A1 (simple extra-articular) fractures (Fig 2) and four had a B2 (medial condylar sagittal plane) fractures; six patients had closed fractures o

Lyons A. Clinical outcomes and treatment of hip fractures. American Journal of Medicine. 1997; 103: 51s 63s. Morrison RS et al. The medical consultant's role in caring for patients with hip fracture. Annals of Int. Med. 1998; 128: 1010-20. Zuckerman J. Hip fracture. NEJM. 1996; 334: 1519-25. sygdom.inf If already in aged care, hip fracture patients are almost never offered rehab in the public system. This was the case for my mother (who had moderate level dementia), the biggest public hospital in Perth deemed her unrehabilitatable and she was sent back to the care facility after 2 days Objectives To develop an evidence and theory-based complex intervention for improving outcomes in elderly patients following hip fracture. Design Complex-intervention development (Medical Research Council (MRC) framework phase I) using realist literature review, surveys and focus groups of patients and rehabilitation teams. Setting North Wales. Participants Surveys of therapy managers (n=13. Hip fracture with mild or moderate dementia can often return to the community if they are provided with active ge-riatric rehabilitation . In a specific study, [14] after examining a relatively large sample of elderly patients after surgery for hip fracture, impaired cognitive status at admission lowered the rehabilitative outcome and wa Dementia has been associated with an increased risk of hip fracture. However, little research has been conducted on the impact of dementia on wrist or vertebral fracture development. The aim of this study was to investigate whether dementia is a risk factor for different types of fracture in Taiwan. The study sample was drawn from Taiwan's National Health Insurance Research Database of.

Rehabilitation strategy for hip fracture, focused on

Following hip fracture, older patients may be cared for in a range of settings ideally with input from both geriatric and orthopaedic specialists.9 At Christchurch Hospital, patients over 65 years with fractures are routinely seen by a HealthCare of the Elderly Physician as a shared care model that helps manage the patient's comorbidities and. There are roughly 280,000 hip fractures diagnosed and treated in the United States annually, and this number is expected to reach 500,000 by the year 2040. The management of these two types of hip fractures is estimated to cost more than eight billion dollars annually. Diagnosis of hip fractures is fairly straight forward

prevalent in patients with dementia after hip fracture regardless of their age. Pre-morbid patient factors may help to identify those patients at risk for depression and should be addressed to optimize rehabilitation participation and outcomes. Introduction. Hip fracture is a disabling medical event in older people an This is an update of a Cochrane Review first published in 2013.Objectives(a) To assess the effectiveness of models of care including enhanced rehabilitation strategies designed specifically for people with dementia following hip fracture surgery compared to usual care.(b) To assess for people with dementia the effectiveness of models of care. After the age of 65 hip fractures become a particularly burdensome event for patients, their families and for the health service 1,2,3,4.They have been associated with increased morbidity, loss of.

Hip Fractures: Most of the Elderly Unlikely to FullyChallenges and rewards of working in trauma orthopaedics

Hip Fracture Management in Advanced Dementia Patients #8

Studies show that people with dementia do not receive the same amount of analgesia after a hip or pelvic fracture compared to those without cognitive impairment. However, there is no systematic review that shows to what extent and how drug-based pain management is performed for people with dementia following a hip or pelvic fracture. The aim of this systematic review is to identify studies. Surgery for Hip Fractures. Surgery is necessary to repair the break after sustaining a hip fracture. This type of surgery requires general anesthesia or spinal anesthesia. Spinal anesthesia includes injecting medicine into the back to numb the patient below the legs. The type of broken hip surgery performed will depend on the kind of fracture.

Management of Acute Hip Fracture | NEJM

(PDF) Rehabilitation after hip fracture in patients with

  1. Intensive in-hospital rehabilitation after hip fracture surgery and activities of daily living in patients with dementia: Retrospective analysis of a nationwide inpatient database. Archives of Physical Medicine and Rehabilitation — Uda K, et al. | August 19, 201
  2. Using many medications, balance issues, as well as vision issues make the elderly very likely to fall after tripping. This is a very common cause of a broken hip or hip fracture. In most cases, you will need surgery to have a hip fracture repaired. The hip can then be repaired or replaced depending on the severity
  3. Setting — Community dwelling older adults following discharge from inpatient rehabilitation facilities in Ontario, Canada. Participants — 17,263 older adults, of whom 2,489 (14.4%) had dementia, who were treated for hip fracture in acute care and then admitted to inpatient rehabilitation facilities between January 1, 2011 and March 31, 2017
  4. Setting the standards for high quality rehabilitation after hip fracture to help transform lives and maximise independence A physiotherapist leads modifying physiotherapy treatment plans to enable patients experiencing dementia, delirium, pain and hypotension to get out of bed on the day of, or the day following
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However, the statistical power of this subgroup analysis was likely insufficient to detect differences between the groups. Dementia was associated with a substantial negative impact on the outcomes following the hip fracture. Our findings support offering interdisciplinary home rehabilitation after hip fracture to people with dementia The authors used the MDS (Minimum Data Set) assessment and linked this to Medicare claims to conduct a cohort study of 3,083 long-staying nursing home residents with advanced dementia and hip fracture. They found, as have other studies of nursing home residents with hip fractures, that patients who underwent surgery had lower mortality rates. Conclusions: The co-occurrence of depression and dementia significantly increases the 12-months risk of dying in elderly patients after rehabilitation post-HF surgery. AB - Objectives: To assess whether the association of depression and dementia affects 12-month survival of elderly patients after rehabilitation post-hip fracture (HF) surgery A hip fracture following a fall is the other primary reason for hip replacement in elderly patients, says Dr. Sharat Kusuma, director of adult reconstruction at Grant Medical Center in Columbus. Advanced dementia patients may be at substantial risk for undetected or undertreated pain. To examine the treatment of pain following hip fracture, a prospective cohort study was conducted in an academic teaching hospital. Fifty-nine cognitively intact elderly patients with hip fracture and 38 patients with hip fracture and advanced dementia. patients with hip fracture in 2012 was estimated to be 175,700 [1]. The final goal of rehabilitation for patients after hip fracture is to return to their own home and regain their pre-fracture level of activity. Several previous studies highlighted the need to restore walking ability and functional status at a