Correlation Between Walking Ability and Monthly Care Costs in Elderly Patients After Surgical Treatments for Hip Fractures

OBJECTIVE: To validate the relationship between residual walking ability and monthly care cost as well as long-term care insurance (LTCI) certification level in elderly patients after surgical treatment for hip fractures in Japan. METHODS: Elderly patients aged >75 years who underwent surgical treatment for hip fractures in our hospital were included. The preand post-surgical (6-month) walking ability and LTCI certification and the presence or absence of dementia was determined from medical records and questionnaires. Walking ability was classified into 6 levels used in our daily medical practice. Based on these data, we correlated the relationship between walking ability and the LTCI certification level. Further, based on the official statistics pertaining to the average monthly costs per person at each LTCI certification level, we evaluated the relationship between walking ability and monthly care cost. RESULTS: A total of 105 cases (mean age, 80.2 years; 16 men; 39 patients with dementia) were included. The correlation between walking ability and average monthly cost per person as well as LTCI certification level at 6 months postoperatively (r=0.58) was demonstrated. The correlation was found in both groups with and without dementia. CONCLUSION: The ability to walk reduced the cost of care in elderly patients who experienced hip fracture, regardless of the presence of dementia.

Effects of Kampo Therapy on Serum Estrogen Levels and Bone Mineral Content in Climacteric Disorder / 日本東洋医学雑誌

Serum estrogen levels and bone mineral contents were measured to study their changes during treatment of climacteric disorder with Kampo therapy.<br>Sixty-five patients who visited the outpatient department of climacteric hormones received either (1) estrogen, (2) Kampo therapy (Saiko-ka-ryukotsu-borei-to, Keishi-bukuryo-gan, or Tokaku-joki-to) or (3) a calcium preparation alone or only psychological therapy (no drug treatment), for six months. Group (3) was treated as the control. Serum E2 levels, bone mineral contents, and cortical bone width index, etc., were determined before and after treatment.<br>In patients treated with Saiko-ka-ryukotsu-borei-to, blood E2 levels increased. In patients treated with Saiko-ka-ryukotsu-borei-to or Tokaku-joki-to, reductions in bone mineral content and the cortical bone width index were suppressed. We therefore concluded that Saiko-ka-ryukotsu-borei-to is effective in preventing osteoporosis. This study also suggests that a combination of Kampo therapy and a calcium preparation may be highly beneficial in preventing menopausal osteoporosis.