Objective: The aims of this study were (1) to investigate the effects of different demographic and perioperative modalities on mortality rates and (2) to compare mortality rates between different implants in elderly patients operated on for hip fractures. Methods: In this retrospective study, a total of 314 patients who were operated on for hip fractures were included study. Patients were then divided into four groups based in their implant types: long-stem cementless bipolar hemiarthroplasty (n = 124; 102 female, 22 male; mean age = 84.2 ± 6.4 years), standard-stem cementless bipolar hemiarthroplasty (n = 74; 48 female, 26 male; mean age = 83.5 ± 6.9 years), antegrade intertrochanteric nail (n = 61; 35 female, 26 male; mean age = 78.5 ± 6.8 years), and total hip arthroplasty (n = 55; 34 female, 21 male; mean age = 72.5 ± 4.3 years). Data including gender, age, duration from injury to surgery, American Society of Anesthesiologists (ASA) score, comorbidities, use of antiplatelet agents, Barthel Index of Activities of Daily Living, type of anesthesia, operation time, preoperative hemoglobin values, blood transfusions given, duration of hospital stay, complications, and type of fracture were recorded. Results: Overall, the mean follow-up was 36.5 (range = 0 – 107) months. The overall mortality rate was 53.2%. The median survival duration was 44.2 ± 5 months (range = 34.3 – 54). Survival rates were found significantly different among the groups (P = 0.001). In the first three years postoperatively, the mortality rate was higher in the standard-stem bipolar hemiarthroplasty group, but in the long-term follow-up, the long-stem bipolar hemiarthroplasty group exhibited the higher mortality rates. It was observed that some parameters had statistically significant effects on the mortality rates. Male gender, higher age, lower hemoglobin values, increased number of blood transfusions, ASA scores ≥3, the existence of ≥ 3 comorbidities were found as main predictors of increased mortality rates. Conclusion: The results of this study have shown that age, gender, preoperative hemoglobin levels, ASA scores, and comorbidities are significant factors affecting mortality in elderly patients operated on for hip fractures. Long-stem cementless bipolar hemiarthroplasty appears to show similar rates of mortality with standard-stem cementless bipolar hemiarthroplasty. Level of Evidence: Level III, Therapeutic Study Cite this article as: Biçen Ç, Akdemir M, Türken MA, et al. Analysis of risk factors affecting mortality in elderly patients operated on for hip fractures: A retrospective comparative study. Acta Orthop Traumatol Turc 2021; 55(6): 493–499.

Objectives: The study aimed to culturally adapt the full version of the Hip Disability and Osteoarthritis Outcome Score (HOOS) into Turkish and evaluate its reliability and validity. Patients and methods: Patients with hip osteoarthritis were included in the methodological crosscultural adaptation study between May 2022 and December 2022. We translated and adapted the HOOS into a Turkish version and validated it in a cohort of native Turkish-speaking patients with hip osteoarthritis. The HOOS includes five subscales named symptoms, pain, activities of daily living (ADL), sport and recreation (Sport/Rec), and quality of life (QoL). The psychometric properties of the Turkish HOOS were assessed. The reliability was investigated using test-retest reliability (intraclass correlation coefficient; ICC) and internal consistency methods (Cronbach’s alpha). The convergent validity of the Turkish HOOS was evaluated by testing the predefined hypotheses using the correlations with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the European Quality of Life Scale (EQ-5D-3L), a generic QoL scale. Results: A total of 202 patients (131 females, 71 males; mean age: 55.2±9.7 years; range, 50 to 70 years) were recruited for the study. Cronbach’s alpha values for each subscale of the HOOS were as follows: symptoms=0.76, pain=0.94, ADL=0.96, Sport/Rec=0.87, QoL=0.78, and total score=0.98, indicating it has high internal consistency. For all subscales and total score of the HOOS, the ICC values were between 0.77 and 0.86, indicating good to excellent test-retest reliability. All correlations between each subscale and total score of the Turkish HOOS, WOMAC, and EQ-5D-3L were moderate to strong. Therefore, 23 predefined hypotheses out of 24 were confirmed with a confirmation rate of 96%, indicating the Turkish version of the HOOS had adequate convergent validity. Conclusion: This study shows that the Turkish version of the HOOS has a convergent and knowngroup validity, internal consistency, and test-retest reliability. It can be used to assess the patient's perception of their hip and associated difficulties, as well as their symptoms and functional limitations.

People with Parkinson’s disease (PD) can develop cognitive and physical impairments. There is limited evidence on the association between executive function and physical function in people with PD....

Technological approaches that promote cognitive-motor abilities through visual information have recently become increasingly prevalent. This study aims to verify the effects of balance-based visual reaction time exercises on physical and cognitive performance in older adults. In this randomized controlled trial, 31 participants (aged 71.70 ± 5.67 years) were randomly allocated into two groups. The intervention group (n = 16) was enrolled in a balanced-based visual reaction exercise program, and the control group (n = 15) in a functional balance exercise program. The participants were assessed both prior to and following the intervention. Primary outcomes included global cognitive function, assessed using the Montreal Cognitive Assessment (MoCA); executive function, measured through the Stroop Test; and reaction time, evaluated using the BlazePod system and the New Test. Secondary outcomes focused on physical performance and included the Five Times Sit-to-Stand Test (FTSS), Timed Up and Go Test (TUG), Four Square Step Test (FSST), Short Physical Performance Battery (SPPB), and the Falls Efficacy Scale (FES) to assess fear of falling. At reassessment, the intervention group exhibited a significantly faster reaction time and made fewer mistakes on the Stroop test compared to the control group (p < 0.05). The intervention group also exhibited better physical performance and less fear of falling (p < 0.05). However, no significant improvements were observed in global cognitive function, as measured by the Montreal Cognitive Assessment (MoCA), or in Stroop Interference scores (p \(\:>\) 0.05). Two-model multiple linear regression analysis revealed that the changes in BlazePod reaction affected the improvement in TUG (β = 0.006, adjusted R² = 0.24) and FES (β = 0.013, adjusted R² = 0.15). In addition, the enhancement in FSST was influenced by changes in the BlazePod stroke (β=-0.585, Delta R² = 0.22). This study demonstrated that balance-based visual reaction time exercises significantly improved reaction time and physical performance in older adults, while no significant changes were observed in executive function measures. These findings highlight the potential of visually guided dual-task training as a feasible strategy to enhance functional outcomes in this population.