Concurrent impact of sarcopenia and cognitive impairment on walking recovery after rehabilitation following hip fracture surgery
Bibliographic record
Abstract
BACKGROUND: Cognitive impairment and sarcopenia each negatively impact functional recovery after hip fracture, yet their combined effects remain underexplored. This study investigated the influence of these conditions on 1-year independent walking recovery in older adults undergoing post-fracture rehabilitation. METHODS: This secondary analysis used data from the Fragility Fracture Integrated Rehabilitation Management clinical trial, a parallel-group, single-blind, multicenter superiority randomized controlled trial, and its preliminary feasibility study. A total of 114 patients aged ≥65 years from three tertiary hospitals in South Korea were included. Patients were classified into four groups based on the presence of cognitive impairment and/or sarcopenia. Walking ability was assessed over a 12-month period. Kaplan-Meier analysis and multivariate Cox regression were used to evaluate independent ambulation rates and associated factors. RESULTS: Patients with sarcopenia had lower independent ambulation rates than those without (71.9% vs. 84.4%; P = .025), as did those with cognitive impairment (65.2% vs. 89.1%; P = .010). The lowest rate was inpatients with both conditions (60.8%, P = .022) and the highest in those without either (90.2%). Post hoc pairwise comparisons confirmed significant differences (P = .011). Cox regression showed cognitive impairment reduced independent ambulation likelihood by 45.8% (HR: 0.542, 95% CI: 0.340-0.865, P = .010), while both conditions together lowered it by 57% (HR: 0.431, 95% CI: 0.233-0.798, P = .007). CONCLUSIONS: Cognitive impairment, especially with sarcopenia, significantly hinders walking recovery after hip fracture. Targeted rehabilitation strategies are crucial to addressing their combined impact in older adults.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".