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Purpose <p>Hip fractures significantly impact health-related quality of life (HRQoL) in older adults. This study aimed to investigate and quantify changes in different domains of HRQoL following a hip fracture and to identify factors associated with maintaining HRQoL (resilience).</p> Methods <p>The study included a cohort of 2,529 individuals aged 65 + who experienced their first hip fracture between 2016 and 2020. HRQoL was assessed using the EQ5D-5L tool both prior to and 4&#xa0;months after the fracture. Resilience was defined as maintaining or improving pre-fracture EQ5D levels at follow-up. Associations between sociodemographic characteristics, acute conditions, medical factors, and resilience in specific EQ5D domains—Mobility, Usual Activities, Self-Care, Pain/Discomfort, and Anxiety/Depression—were analyzed using regression models.</p> Results <p>Sixty-nine percent were women and the mean age was 82.6&#xa0;years. A decline was observed across all EQ5D domains and in the global EQ5D index following a hip fracture. The proportion of patients exhibiting resilience varied by domain, ranging from 36 to 77%, with Mobility being the most adversely affected and Anxiety/Depression the least affected. Factors associated with resilience differed by domain. Mobility, Usual Activities, and Self-Care followed a similar pattern, while Pain/Discomfort and Anxiety/Depression showed distinct patterns. Notably, the absence of fall-risk-increasing medications was the only factor consistently associated with resilience across all domains.</p> Conclusions <p>While hip fractures generally lead to declines in HRQoL, a significant proportion of patients demonstrate resilience within 4&#xa0;months post-fracture. Patterns of resilience vary across EQ5D domains, with physical functions being most impacted and mental health the least.</p>

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The impact of hip fracture on resilience in health-related quality of life: a cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月29日

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  • Stina Ek,
  • Mozhu Ding,
  • Margareta Hedström,
  • Stefan Fors,
  • Karin Modig

摘要

Purpose

Hip fractures significantly impact health-related quality of life (HRQoL) in older adults. This study aimed to investigate and quantify changes in different domains of HRQoL following a hip fracture and to identify factors associated with maintaining HRQoL (resilience).

Methods

The study included a cohort of 2,529 individuals aged 65 + who experienced their first hip fracture between 2016 and 2020. HRQoL was assessed using the EQ5D-5L tool both prior to and 4 months after the fracture. Resilience was defined as maintaining or improving pre-fracture EQ5D levels at follow-up. Associations between sociodemographic characteristics, acute conditions, medical factors, and resilience in specific EQ5D domains—Mobility, Usual Activities, Self-Care, Pain/Discomfort, and Anxiety/Depression—were analyzed using regression models.

Results

Sixty-nine percent were women and the mean age was 82.6 years. A decline was observed across all EQ5D domains and in the global EQ5D index following a hip fracture. The proportion of patients exhibiting resilience varied by domain, ranging from 36 to 77%, with Mobility being the most adversely affected and Anxiety/Depression the least affected. Factors associated with resilience differed by domain. Mobility, Usual Activities, and Self-Care followed a similar pattern, while Pain/Discomfort and Anxiety/Depression showed distinct patterns. Notably, the absence of fall-risk-increasing medications was the only factor consistently associated with resilience across all domains.

Conclusions

While hip fractures generally lead to declines in HRQoL, a significant proportion of patients demonstrate resilience within 4 months post-fracture. Patterns of resilience vary across EQ5D domains, with physical functions being most impacted and mental health the least.