Dementia doubles the mortality risk 1 year after hip fracture

In a retrospective analysis of over 111,000 Swedish patients, patients with dementia had significantly higher mortality rates at 30 days, 4 months, and 1 year following hip fracture surgery, compared with patients without a diagnosis of dementia. These findings underscore the need for specialised post-operative care.

The lifetime risk for a hip fracture in Swedish women and men is 23% and 11%, respectively; dementia doubles this risk, said Prof. Dorota Religa (Karolinska Institutet, Sweden) [1]. Hip fractures are a major cause of morbidity and mortality among the elderly. Dementia is common in this population and complicates recovery from hip fracture surgery, which is the only treatment option. Previous studies have suggested an increased mortality risk in hip fracture patients with dementia, but had several limitations, such as small sample sizes and limited data on dementia subtypes.

To gain insight into the exact association between dementia and mortality after hip fracture surgery, Prof. Religa and colleagues conducted a retrospective cohort analysis including 111,353 Swedish patients aged ≥65 years who underwent hip fracture surgery between 2010 and 2018 [1]. Prof. Religa noted that 22% of the total study cohort had a dementia diagnosis. To examine the impact of dementia subtypes on mortality outcomes, 9 different subtypes were distinguished.

Not surprisingly, mortality rates after hip fracture surgery were higher in the group with dementia: mortality rates were 13% versus 6% (P<0.001) at 30 days post-fracture; 27% versus 12% (P<0.001) at 4 months; and 39% versus 20% (P<0.001) at 1 year. Of the different dementia types, Parkinson’s disease was associated with the highest mortality, especially in the first 4 months after surgery. Prof. Religa added that higher American Society of Anaesthesiologists (ASA) grades, fracture type, poor baseline walking ability, and long-term care residency were also associated with increased mortality.

1. Religa D, et al. Mortality after hip fracture surgery in patients with dementia: large Swedish study of over 111 000 patients. OPR-067, EAN Congress 2025, 21-24 June, Helsinki, Finland.

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Posted on 3 September 2025