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Hip Fractures May Signal Alzheimer's

Johns Hopkins study finds biomarker for brain decline in hospitalized patients

Hip Fracture x-ray

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For older adults, a broken hip could be a sign of brain problems, including undiagnosed Alzheimer’s disease, according to recent findings from Johns Hopkins researchers.

Their study, published in September in the journal PLOS ONE, found that a majority of older adults hospitalized for hip fractures had biomarkers for Alzheimer’s in their spinal fluid, even among patients who had no clinical diagnosis or signs of dementia.

The findings, which were based on spinal fluid samples from 168 hip-fracture patients ranging in age from 65 to 102, add to our understanding of how brain changes in older adults that lead to poor balance may be linked to both increased risk of hip-fracturing falls and Alzheimer’s disease. But they need to be interpreted with caution, says lead study author Esther Oh, associate professor of medicine at the Johns Hopkins University School of Medicine.

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“Just because you have a biomarker positive [result] by laboratory standards doesn’t mean you have Alzheimer’s disease,” she says. Nor is she advocating that patients hospitalized with broken hips undergo biomarker testing, or that people who are experiencing gait or balance problems assume they have Alzheimer’s. (Those problems can be caused by a range of factors, including nerve damage and vision issues.)

Instead, Oh hopes to alert patients, doctors and caregivers to one risk in particular faced by those undergoing surgery to repair a hip fracture after a fall: postoperative delirium, a severe state of confusion that can hinder rehabilitation efforts while causing lasting effects on the brain — and which patients with Alzheimer’s are more likely to experience.

“We really need to pay attention to people who break their hips,” she says. “Having somebody right by their bedside, reorienting a patient, making sure they are taking fluids — there are very, very simple things we can do to reduce the risk of delirium.”

As for the association between hip fractures and Alzheimer's disease, Oh is continuing to monitor the study participants’ post-surgery outcomes, including any clinical signs of dementia.



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