Kudos to Michelle Tingzhong Xue, PhD student, her sponsor Eleanor McConnell, associate professor, and her entire team for the submission of her Sigma Theta Tau International application entitled: “Dynamics of Multimorbidity, Dementia-Related Symptoms and Functional Recovery Trajectories in Nursing Home Residents with Dementia after Hip Fracture Surgery.” This proposal requests funding for a one-year period with a project start date of June 1, 2021.

Objectives: Examine longitudinal relationships between dementia-related symptoms and physical function recovery, and the moderation effects of multimorbidity over one year after hip fracture surgery in nursing home residents with dementia, guided by the working model of physical resilience.

Subject Population: Nursing home residents over 65 years old with dementia and a hip fracture surgery who survived at least one year after the surgery. Research Design: Secondary data analysis on the Minimum Data Set (MDS) 3.0. from year 2011 to 2014.

Instruments: Variables will be constructed from MDS 3.0 items as follows: depression (the Patient Health Questionnaire), cognition (the MDS 3.0 Cognitive Function Scale), behavioral symptoms (section E in MDS 3.0), pain intensity and frequency (section J), nutrition (section K), activities of daily living (section G), range of motion (section G) and balance (section G), multimorbidity (ICD diagnosis codes and section I).

Procedure: Descriptive statistics will be used to describe patient characteristics and organizational factors. Variables needed for analyzing aims will then be constructed using multi-trajectory modeling and latent class analysis. To address aims examining longitudinal relationships between dementia-related symptoms and physical function recovery, and the moderation effects of multimorbidity, multinomial logistic regressions will be applied.

This study will serve as a foundation for future development of individualized interventions for promoting physical function recovery, an indicator of physical resilience, and will deepen our understanding of physical resilience in older adults with dementia who have a hip fracture, taking into consideration classes of multimorbidity.