Cognitive impairment has been found to be associated with an increased risk of falls among older adults. The aim of this study was to compare in-hospital outcomes such as time-to-surgery, complications, length of stay, intensive care utilization, post-operative mobility and discharge disposition of older adults presenting with or without cognitive impairment who underwent surgical treatment for a low energy hip fracture. We identified 255 patients (women > 55 years, men > 60 years) with hip fracture treated during an 18-month period (5/2/11-11/29/12) while patient demographic and hospitalization data were examined. During the 18-month period, 30% presented with a diagnosis consistent with cognitive impairment (e.g. dementia, Alzheimer's disease, Lewy body, vascular dementia). Complication rates were higher among the cognitively-impaired patients versus those without cognitive impairment (p=0.0647). Moreover, 31% of cognitively-impaired patients experienced delirium compared to 14% of those without cognitive impairment (p=0.001), while 23% of cognitively-impaired patients had urinary tract infections (UTI) compared to 9% among those without cognitive impairment (p=0.002). There was no difference in the overall inpatient complication rates between both categories; however, cognitively-impaired patients were more likely to experience complications such as delirium and UTI. Based on these findings, we recommend systematic assessment of cognitive status on admission and identification of cognitive impairment. The recognition of the most common complications will allow clinicians to create focused clinical pathways to help decrease complications in cognitively-impaired