Article

Purpose: To examine if there is an association between brain computed tomography (CT) findings and place of residence in a series of hip fracture patients. Method: The CT scans taken immediately after hip fracture of 215 patients ( mean age 81.6 years) living in their own homes or otherwise independently ( home-dwelling group) and 95 patients ( mean age 82.5 years) permanently institutionalized ( institutionalized group) were analysed. Results: The institutionalized patients had significantly more cortical cerebral ( frontal, p = 0.004; temporal, p = 0.007; parietal, p < 0.001) and central cerebral ( third ventricle width, p < 0.001; frontal horn width, p < 0.001; midbody width, p < 0.001) atrophy than the home-dwelling ones. This was also true of atrophy in the white-matter (WM) area ( p < 0.001). The institutionalized patients also had more atrophy of the cerebellar hemisphere ( atrophy of the cerebellopontine angle cistern, p = 0.002, greater fourth ventricle width, p = 0.020). No significant difference was seen in the incidence of brain infarcts. Conclusions: Hip fracture patients living in institutions have more brain atrophy than those living independently. The brain atrophy may be one factor in the multiple mechanism underlying their institutional admission.

Langue : ANGLAIS