{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T02:36:21Z","timestamp":1746585381981,"version":"3.37.3"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T00:00:00Z","timestamp":1649116800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014422","name":"Eli Lilly Japan","doi-asserted-by":"publisher","award":["the Eli Lilly Japan KK Research Grant"],"award-info":[{"award-number":["the Eli Lilly Japan KK Research Grant"]}],"id":[{"id":"10.13039\/100014422","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Cognitive function is an important factor that affects functional recovery after hip fracture (HipFx) surgery. The literature on the pathophysiology of dementia in HipFx patients is scarce. We performed a differential diagnosis of dementia in HipFx patients using clinical and brain MRI findings.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This is a prospective study in which brain MRI was evaluated for patients with HipFx for research purposes. One-hundred-and-five HipFx patients (85 females and 20 males) who underwent surgery and were subsequently able to undergo brain MRI at our hospital were evaluated. The mean age was 84 years. The presence of dementia was determined based on clinical findings and whether the patient meets its diagnostic criteria according to the International Classification of Diseases 10th Edition (ICD-10). The differential diagnosis of dementia was made based on brain MRI findings and the dementia diagnostic flow chart published in the Clinical Practice Guideline for Dementia 2017 (Japanese Society of Neurology). The Voxel-based Specific Regional Analysis System for Alzheimer\u2019s Disease (VSRAD) advance 2 diagnostic software was used to evaluate atrophy of the para-hippocampal gyrus.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Fifty-six (53%) patients were clinically diagnosed with dementia according to the ICD-10 criteria. The MRI findings were diverse: Alzheimer\u2019s disease (AD)-type, asymptomatic multiple ischemic cerebral lesions, past symptomatic cerebral infarction or cerebral hemorrhage, Binswanger\u2019s disease (BW)-type, chronic subdural hematoma, disproportionately enlarged subarachnoidal hydrocephalus (DESH), and their combinations thereof. A combination of MRI and clinical findings of dementia patients demonstrated the following distribution of dementia subtypes: AD (n = 20), vascular dementia (n = 33), AD and BW vascular dementia (n = 3).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>This study revealed that the brain MRI findings of HipFx patients were diverse. Although vascular dementia is found to be common in this particular population, this could be an incidental finding. Further study is warranted to clarify the specificity of our findings by increasing the number of patients, setting the control, and investigating whether dementia subtypes affect postoperative gait acquisition and fall risk.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0265636","type":"journal-article","created":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T17:26:40Z","timestamp":1649179600000},"page":"e0265636","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["What is the subtype of dementia in patients with fragility hip fracture?"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5398-7895","authenticated-orcid":true,"given":"Shigeharu","family":"Uchiyama","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumiki","family":"Kamoi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manabu","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Itsuo","family":"Joko","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuo","family":"Kasuga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenta","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoko","family":"Tachibana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoki","family":"Kaneko","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoji","family":"Amano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,4,5]]},"reference":[{"key":"pone.0265636.ref001","unstructured":"Statistics Bureau of Japan https:\/\/www.stat.go.jp\/data\/topics\/topi"},{"issue":"5","key":"pone.0265636.ref002","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1016\/j.jos.2017.06.003","article-title":"Survey of hip fractures in Japan: Recent trends in prevalence and treatment","volume":"22","author":"H Hagino","year":"2017","journal-title":"J Orthop Sci"},{"issue":"292","key":"pone.0265636.ref003","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1097\/00003086-199307000-00027","article-title":"Femoral neck fracture. Factors related to ambulation and prognosis","author":"T Kyo","year":"1993","journal-title":"Clin Orthop Relat Res"},{"issue":"1","key":"pone.0265636.ref004","first-page":"158","article-title":"Fragility Fracture Network (FFN) Rehabilitation Research Special Interest Group. BMC. A critical review of the long-term disability outcomes following hip fracture","volume":"16","author":"SM Dyer","year":"2016","journal-title":"Geriatr"},{"key":"pone.0265636.ref005","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1302\/0301-620X.100B9.BJJ-2017-1342.R1","article-title":"Dementia predicted one-year mortality for patients with first hip fracture: a population-based study","volume":"100-B","author":"HC Chiu","year":"2018","journal-title":"Bone Joint J"},{"key":"pone.0265636.ref006","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1007\/s00198-019-04944-5","article-title":"Timeline of functional recovery after hip fracture in seniors aged 65 and older: a prospective observational analysis","volume":"30","author":"K Fischer","year":"2019","journal-title":"Osteoporos Int"},{"key":"pone.0265636.ref007","unstructured":"Ministry of Health, Labor and Welfare, FY2018 Overview of Statistics on Long-term Care Benefits, etc. https:\/\/www.mhlw.go.jp\/toukei\/saikin\/hw\/kaigo\/kyufu\/18\/index.html"},{"key":"pone.0265636.ref008","article-title":"Study on future estimation of the elderly population with dementia in Japan. Ministry of Health, Labor and Welfare Research Grants Administrative Policy Research Field","author":"T Ninomiya","year":"2014","journal-title":"Special Research on Health, Labor and Welfare Science 05037A"},{"issue":"2","key":"pone.0265636.ref009","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1177\/2151458510389463","article-title":"Dementia and hip fractures: development of a pathogenic framework for understanding and studying risk","volume":"1","author":"SM Friedman","year":"2010","journal-title":"Geriatr Orthop Surg Rehabil"},{"key":"pone.0265636.ref010","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.physio.2017.01.001","article-title":"Physiotherapy interventions for people with dementia and a hip fracture-a scoping review of the literature","volume":"103","author":"AJ Hall","year":"2017","journal-title":"Physiotherapy"},{"key":"pone.0265636.ref011","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1186\/s12883-014-0175-2","article-title":"Increased risk of hip fractures in patients with dementia: a nationwide population-based study","volume":"14","author":"HK Wang","year":"2014","journal-title":"BMC Neurol"},{"key":"pone.0265636.ref012","article-title":"The effects of dementia on the prognosis and mortality of hip fracture surgery: a systematic review and meta-analysis","author":"M Hou","year":"2021","journal-title":"Aging Clin Exp Res"},{"issue":"1","key":"pone.0265636.ref013","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1186\/s13018-018-0988-6","article-title":"Association between dementia and mortality in the elderly patients undergoing hip fracture surgery: a meta-analysis","volume":"13","author":"J Bai","year":"2018","journal-title":"J Orthop Surg Res"},{"key":"pone.0265636.ref014","first-page":"CD010569","article-title":"Enhanced rehabilitation and care models for adults with dementia following hip fracture surgery","volume":"2","author":"TO Smith","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"pone.0265636.ref015","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.2147\/CIA.S69244","article-title":"Comparison of activities of daily living after osteoporotic hip fracture surgery in patients admitted from home and from geriatric health service facilities","volume":"9","author":"A Horikawa","year":"2014","journal-title":"Clin Interv Aging"},{"key":"pone.0265636.ref016","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1159\/000480497","article-title":"Fear of falling and cognitive impairments in elderly people with hip fractures","volume":"7","author":"M Kasai","year":"2017","journal-title":"Dement Geriatr Cogn Dis Extra"},{"key":"pone.0265636.ref017","doi-asserted-by":"crossref","first-page":"e0200143","DOI":"10.1371\/journal.pone.0200143","article-title":"Rehabilitation strategy for hip fracture, focused on behavioral psychological symptoms of dementia for older people with cognitive impairment: A nationwide Japan rehabilitation database","volume":"13","author":"K Shibasaki","year":"2018","journal-title":"PLoS One"},{"volume-title":"International Statistical Classification of Diseases and Related Health Problems 10th Revision","year":"1993","author":"World Health Organization","key":"pone.0265636.ref018"},{"key":"pone.0265636.ref019","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.3174\/ajnr.A2935","article-title":"Automatic voxel-based morphometry of structural MRI by SPM8 plus diffeomorphic anatomic registration through exponentiated lie algebra improves the diagnosis of probable Alzheimer Disease","volume":"33","author":"H Matsuda","year":"2012","journal-title":"AJNR Am J Neuroradiol"},{"key":"pone.0265636.ref020","doi-asserted-by":"crossref","first-page":"351","DOI":"10.2214\/ajr.149.2.351","article-title":"MR signal abnormalities in Alzheimer\u2019s disease and normal aging","volume":"49","author":"F Fazekas","year":"1987","journal-title":"AJR Am J Roentgenol"},{"key":"pone.0265636.ref021","unstructured":"How to proceed with diagnostic imaging of dementia. Chapter 2 Symptomatology, evaluation scale, examination, diagnosis. Clinical Practice Guidelines for Dementia 2017. p 39\u201341. https:\/\/www.neurology-jp.org\/guidelinem\/nintisyo_2017.html"},{"key":"pone.0265636.ref022","unstructured":"What are the characteristics and diagnostic points of neuropsychiatric symptoms of Alzheimer\u2019s disease? Chapter 6 Alzheimer\u2019s disease in Clinical Practice Guidelines for Dementia 2017 p.206 https:\/\/www.neurology-jp.org\/guidelinem\/nintisyo_2017.html"},{"key":"pone.0265636.ref023","unstructured":"What are the diagnostic criteria for vascular dementia (VaD)? Chapter 14 Vascular dementia in Clinical Practice Guidelines for Dementia 2017 p305 https:\/\/www.neurologyjp.org\/guidelinem\/nintisyo_2017.html"},{"key":"pone.0265636.ref024","doi-asserted-by":"crossref","first-page":"1978","DOI":"10.1016\/j.injury.2012.08.061","article-title":"HEALTH and FAITH investigators. Bias towards dementia: are hip fracture trials excluding too many patients? A systematic review","volume":"43","author":"J Hebert-Davies","year":"2012","journal-title":"Injury"},{"key":"pone.0265636.ref025","article-title":"The effects of dementia on the prognosis and mortality of hip fracture surgery: a systematic review and meta-analysis","author":"M Hou","year":"2021","journal-title":"Aging Clin Exp Res"},{"key":"pone.0265636.ref026","doi-asserted-by":"crossref","first-page":"421","DOI":"10.2147\/CIA.S115945","article-title":"Dementia and delirium, the outcomes in elderly hip fracture patients","volume":"12","author":"CA Mosk","year":"2017","journal-title":"Clin Interv Aging"},{"key":"pone.0265636.ref027","first-page":"64","article-title":"Study design and baseline characteristics of a population-based prospective cohort study of dementia in Japan: the Japan Prospective Studies Collaboration for Aging and Dementia (JPSC-AD)","volume":"1","author":"JPSFC-AD Study Group","year":"2020","journal-title":"Environ Health Prev Med"},{"issue":"11","key":"pone.0265636.ref028","first-page":"1339","article-title":"Development of the revised version of Hasegawa\u2019s Dementia Scale (HDS-R)","volume":"2","author":"S Katoh","year":"1991","journal-title":"Jpn J Geriat"},{"key":"pone.0265636.ref029","doi-asserted-by":"crossref","first-page":"69","DOI":"10.3995\/jstroke.10354","article-title":"The origin and clinical importance of WML","volume":"38","author":"T. Imaizumi","year":"2016","journal-title":"Jpn J Stroke"},{"key":"pone.0265636.ref030","doi-asserted-by":"crossref","first-page":"892","DOI":"10.3143\/geriatrics.30.892","article-title":"MRI study of the brain in aged volunteers:T2 high signal intensity lesions and high cortical function","author":"H Kasahara","year":"1993","journal-title":"Jpn J Geriat"},{"key":"pone.0265636.ref031","doi-asserted-by":"crossref","first-page":"721","DOI":"10.3143\/geriatrics.35.721","article-title":"Silent brain infarction in elderly","volume":"35","author":"S. 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