To prove the efficiency of a specialized geriatric ward (cognitive geriatric unit, CGU) for patients with a fracture of the proximal femur and additional
dementia, we conducted a matched-pair analysis comparing 96 patients with fracture of the proximal femur and additional
dementia matched for age, sex, surgical treatment and the degree of
cognitive impairment by MMSE score. A total of 48 patients were treated in the CGU, offering extended geriatric assessment, special education of staff, and architecture appropriate for patients with
cognitive decline. Target criteria were a gain in the Barthel index and Tinetti score, the
length of stay, new admissions to
nursing home, the frequency of
neuroleptic,
antidepressant, and antidementive medication, and the number of specified clinical diagnoses for the
dementia syndrome.
Length of stay was significantly longer in the CGU. The increase of the Tinetti score was significantly higher in the patients in the CGU, regardless of the
length of stay (analysis of covariance: treatment (CGU/non-CGU): F(1/93) = 9.421, p = 0.003; covariate (
length of stay): F(1/93) = 3.452, p = 0.066, η(2) = 3.6%). In the intervention group, the number of definite diagnoses concerning the
dementia syndrome was also higher. Comparison of drug treatment and the percentage of new admission to a
nursing home did not differ between groups. Treatment in a specialized, "cognitive geriatric unit" seems to result in better mobility of demented patients with proximal fractures of the femur.