Six years after a hip fracture, function has not come back

The edition in brief

Today's geriatrics edition opens with culturally adapted post-diagnostic dementia support for South Asian families — twelve studies, mostly carer education and psychoeducation, showing feasibility and improved carer knowledge, confidence and mental health, with the striking gap that almost nothing targets the person with dementia directly. A nine-year cohort from the China Health and Retirement Longitudinal Study, covering 25,873 participants of whom 719 sustained a hip fracture, found an immediate rise of 0.580 activities-of-daily-living difficulties, recovery that never completes — difficulties remained 25% above pre-fracture level at six years — and two effect modifiers: the 70-to-79 group lost the most function immediately, while those aged 80 and over continued to deteriorate during the recovery period rather than improving. A systematic review of 35 cohorts and over 365,000 people establishes normal forced vital capacity decline at roughly 20 to 30 mL per year, linear in women at about 26 mL and biphasic in men at about 22 mL before 40 and 36 mL after. A pilot randomised trial in 51 patients with mild to moderate frailty found four weeks of resistance-focused prehabilitation before coronary or valve surgery improved Short Physical Performance Battery scores by about one point and reduced Fried frailty category, with 89% adherence, though no difference in readmission or length of stay. The practice-changer is a network meta-analysis of 124 trials and 18,429 adults over 40, giving a modality and a dose for bone: brisk walking or jogging at around 600 metabolic equivalent minutes a week, with an inverted-U response.