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OBJECTIVE: To evaluate the role of delirium in the natural history of functional recovery after hip fracture surgery, independent of prefracture status.

DESIGN: Prospective cohort study.

SETTING: Orthopedic surgery service at a large academic tertiary hospital, with follow‐up extending into rehabilitation hospitals, nursing homes, and the community.

PARTICIPANTS: One hundred twenty‐six consenting subjects older than 65 years (mean age 79 ± 8 years, 79% women) admitted emergently for surgical repair of hip fracture.

MEASUREMENTS: Detailed assessment at enrollment to ascertain prefracture status through interviews with the patient and designated proxy and review of the medical record. Interviews included administration of standardized instruments (Activities of Daily Living (ADL) Scale, Blessed Dementia Rating Scale, Delirium Symptom Interview) and assessment of ambulation, and prefracture living …