Abstract

Background: Geriatric population includes patients above 65 (sixty five years). They are susceptible to fractures around Hip joint. It can be intracapsular, intertrochantericor subtrochanteric patients. They have various co-morbidities and surgical outcome largely depends on their cognitive status even if the orthopaedic surgical fixation and medical management is excellent.

This study aims at assessing the cognitive function of patients above 65 years on the basis of a minimental state score questionnaire.

If the score is on the lower side the relatives and care givers are warned of a less favourable outcome even if surgery is done.

Materials and Methods: This is a prospective study of 60 (sixty) patients; both male and female admitted in Government Medical College, Trivandrum from 2019-20 (May). All patients had varying types of Hip fractures, they also had comorbidities like diabetes mellitus, hypertension, CVA. The focus was on cognitive function traced on Minimental state questionnaire. It includes vertbal, as well as writing and reading components. A total sense of 30 points is the maximum. Patients having sure of 27-30 were considered normal with no significant dementia.

A score of 23-27 was considered borderline score below 23 had significant cognitive disturbance.

Results: Forty four (44) patients above the age of 65 (sixty five) had significant cognitive impairment according to this scale, 21 had scores below 23 out of 30. However they were in the age group of 85 and above.

Hence assessment of mental state is a good guide to predict the functional outcome of the planned orthopedic surgery.

Conclusion: Dementia or rather cognitive disturbances are common in elderly. Awareness of this fact is equally important for the surgeon who makes the decision to operate and also to inform the care givers.

Operating on a demented patient will be a surgical exercise and a burden for the relatives.