The primary objective of the proposed research is to investigate the association between protein intake and nutritional status with bone health and physical functioning in older hip fracture patients. In addition, it will be investigated which patient characteristics and modifiable factors can predict mobility, clinical frailty, living situation and mortality. This study will be a 3-month prospective cohort study in adults aged 70 years and older with an acute hip fracture. This study will lead to knowledge about how protein intake and nutritional status in combination with patient characteristics can predict the degree of recovery (bone health and physical functioning) 3 months after the hip fracture. Knowledge on factors related to recovery can contribute to an improved and shorter rehabilitation in the future, which results in a reduction of health care costs.
Only half of the patients with an acute hip fracture regain their pre-fracture functional level and 24% dies within the following year. Identifying and targeting modifiable risk factors for optimal recovery after a hip fracture is therefore essential. These factors include protein intake and nutritional status, which may affect markers of bone health and physical functioning and thereby influence recovery. Measurements will be performed at baseline (within 5 days after the hip surgery) and after 3 months during an outpatient clinic visit for the evaluation of the hip fracture surgery. A total of 95 older adults (aged 70 years or older) recovering from an acute hip fracture will be recruited from Rijnstate hospital.
Study Type
OBSERVATIONAL
Enrollment
95
Rijnstate Hospital
Arnhem, Netherlands
Protein intake
Dietary protein intake will be recorded using a protein screener which gives an indication of protein intake in g/d. Based on the past 4 weeks.
Time frame: Baseline
Protein intake
Dietary protein intake will be recorded using a protein screener which gives an indication of protein intake in g/d. Based on the past 4 weeks.
Time frame: Three months
Nutritional status
Using the Mini Nutritional Assessment Short Form. Subjects will be classified as having a normal nutritional status (12-14 points), having a risk of malnutrition (8-11 points), or being undernourished (0-7 points).
Time frame: Baseline
Nutritional status
Using the Mini Nutritional Assessment Short Form. Subjects will be classified as having a normal nutritional status (12-14 points), having a risk of malnutrition (8-11 points), or being undernourished (0-7 points).
Time frame: Three months
Procollagen type 1 N propeptide
Bone turnover marker, in serum
Time frame: Baseline
Procollagen type 1 N propeptide
Bone turnover marker, in serum
Time frame: Three months
C-terminal telopeptide of type I collagen
Bone turnover marker
Time frame: Baseline
C-terminal telopeptide of type I collagen
Bone turnover marker
Time frame: Three months
Calcaneus quantitative ultrasound parameters
Ultrasound of the calcaneus which gives an indication of the bone density. Device yields the following two parameters: speed of sound (SOS) and broadband ultrasound attenuation (BUA), which can be combined to get the Stiffness Index (SI).
Time frame: Baseline
Calcaneus quantitative ultrasound parameters
Ultrasound of the calcaneus which gives an indication of the bone density. Device yields the following two parameters: speed of sound (SOS) and broadband ultrasound attenuation (BUA), which can be combined to get the Stiffness Index (SI).
Time frame: Three months
Insulin-like growth factor 1
In serum
Time frame: Baseline
Insulin-like growth factor 1
In serum
Time frame: Three months
Parathyroid hormone levels
In serum
Time frame: Baseline
Parathyroid hormone levels
In serum
Time frame: Three months
Handgrip strength
Using the Martin vigorimeter
Time frame: Baseline
Handgrip strength
Using the Martin vigorimeter
Time frame: Three months
Grip work
Using the Martin vigorimeter
Time frame: Baseline
Grip work
Using the Martin vigorimeter
Time frame: Three months
Appendicular skeletal muscle mass
Using bioimpedance spectroscopy
Time frame: Baseline
Appendicular skeletal muscle mass
Using bioimpedance spectroscopy
Time frame: Three months
Mobility
Pre-fracture mobility will be assessed with the pre-fracture mobility scale (PMS). The PMS classifies the patient as independent walker, walk with rollator, in a wheelchair or bedridden.
Time frame: Baseline
Mobility
Mobility at 3 months will be assessed with the Functional Ambulation Categories (FAC). The FAC is scaled from 0 to 5, in which zero means that patient cannot walk or need at least two persons to help and five means independent walker.
Time frame: Three months
Frailty
Frailty will be assessed with the Clinical Frailty Scale. This scale is graded from 1 to 9 in which level 1 represents 'very fit' and level 9 'terminally ill'.
Time frame: Baseline
Frailty
Frailty will be assessed with the Clinical Frailty Scale. This scale is graded from 1 to 9 in which level 1 represents 'very fit' and level 9 'terminally ill'.
Time frame: Three months
Bodyweight
Bodyweight (kg) will be measured with a calibrated sitting weighing scale.
Time frame: Baseline
Bodyweight
Bodyweight (kg) will be measured with a calibrated sitting weighing scale.
Time frame: Three months
Barthel Index
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This questionnaire determines the degree of (physical or verbal) help a person needs to perform general daily activities. It is graded from 0 (person is completely dependent on others) to 20 (person is completely independent).
Time frame: Baseline
Barthel Index
This questionnaire determines the degree of (physical or verbal) help a person needs to perform general daily activities. It is graded from 0 (person is completely dependent on others) to 20 (person is completely independent).
Time frame: Three months