10-Year Survival After Acute Hip Fracture in Patients With Preclinical/Clinical Alzheimer Pathology

10-Year Follow-up of Mortality in Patients With Acute Hip Fractures: Associations With Pre-Alzheimer's/Alzheimer's Disease and Cerebrospinal Fluid Biomarkers

This study is a 10-year follow-up of a previously enrolled cohort of patients who underwent surgery for acute hip fracture with spinal anesthesia and had pre-fracture cognitive status assessed (Clinical Dementia Rating, CDR) and cerebrospinal fluid (CSF) biomarkers related to Alzheimer's disease measured (e.g., Aβ42/Aβ40 ratio, total tau, phosphorylated tau). The primary aim is to determine long-term survival at 10 years after index hip fracture surgery and to evaluate whether baseline cognitive status and/or Alzheimer-type CSF biomarker profiles are associated with long-term mortality.

Study Overview

• Status: Completed
• Conditions: Dementia; Hip Fractures (ICD-10 72.01-72.2); Alzheimer s Disease

Detailed Description

Participants were originally included during admission for acute hip fracture (October 2013-June 2015) at Sahlgrenska University Hospital, Mölndal, Sweden, and underwent lumbar CSF sampling at spinal anesthesia induction. Cognitive status prior to the fracture was assessed using CDR. Mortality will be ascertained through Swedish national registries. The follow-up extends survival assessment to approximately 10 years after surgery. Analyses will compare survival across baseline cognitive status categories and biomarker-defined groups (e.g., normal vs abnormal Aβ42/Aβ40 ratio), and may adjust for baseline covariates (e.g., age, sex, ASA class / hip fracture risk scores if available from original dataset).

• Study Type: Observational
• Enrollment (Actual): 404

Contacts and Locations

Study Locations

• Sweden
  • Västra Götaland County
    • Mölndal, Västra Götaland County, Sweden, 431 80
      • Sahlgrenska University Hospit

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Older adults (≥65 years) who were admitted for acute hip fracture and underwent surgical repair under spinal anesthesia at Sahlgrenska University Hospital, Mölndal, Sweden. Participants were originally enrolled between October 2013 and June 2015 and had pre-fracture cognitive status assessed using the Clinical Dementia Rating scale and cerebrospinal fluid biomarkers related to Alzheimer's disease collected at baseline. The present study is a long-term follow-up of this cohort.

Description

Inclusion Criteria:

• Participant enrolled in the original acute hip fracture cohort (index surgery during Oct 2013-Jun 2015 at Sahlgrenska University Hospital, Mölndal)
• Available personal identity number enabling linkage to Swedish registries
• Baseline cognitive assessment (CDR) and/or CSF biomarker data available from the index admission

Exclusion Criteria:

Missing linkage information preventing ascertainment of vital status

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Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
All-cause mortality / survival at 10 years after index hip fracture surgery	up to 10 years post-surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Time to death from date of surgery (survival time)	All-cause mortality /survival at 10 years after index hip fracture surgery	10 years ( up to 10 years post-surgery)
Association between baseline CDR category and long-term mortality		up to 10 years

Collaborators and Investigators

• Sponsor: Bengt Nellgård

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2013
• Primary Completion (Actual): June 1, 2015
• Study Completion (Actual): June 1, 2015

Study Registration Dates

• First Submitted: February 25, 2026
• First Submitted That Met QC Criteria: February 25, 2026
• First Posted (Actual): March 2, 2026

Study Record Updates

• Last Update Posted (Actual): March 2, 2026
• Last Update Submitted That Met QC Criteria: February 25, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Mental Disorders; Wounds and Injuries; Leg Injuries; Neurocognitive Disorders; Fractures, Bone; Femoral Fractures; Hip Injuries; Hip Fractures; Dementia
• Other Study ID Numbers: HOFTDEM_10 years

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No