Rehabilitation of the older stroke patient - Functional outcome and comparison with younger patients

Objective: To evaluate the inpatient rehabilitation progress and functional outcome of stroke patients aged 80 yr and over and make comparisons with a younger (< 80 yr) stroke population receiving similar comprehensive rehabilitation therapies. Design: A case series of 223 stroke patients consecutively admitted to the inpatient rehabilitation unit of a tertiary acute general hospital. A total of 44 patients with a first-time stroke were at least 80 yr old and over and 179 initial stroke patients were < 80 yr old. The main outcome measures included admission and discharge scores of the FIM(TM) instrument, FIM gain and efficiency, and discharge disposition. Results: The majority (72.7%) of the older stroke group (mean age, 84 yr; standard deviation, 3.7 yr; range, 80-94 yr) was able to return home, although to a lesser extent than the younger segment (90.5%). No continuous or categorical variable studied was related to discharge disposition in the older stroke patients. Admission FIM total was the most significant predictor of discharge FIM total and discharge FIM motor. The older group did have a lower FIM efficiency and made smaller FIM total and motor gains. In comparison with the younger stroke patients, the older stroke group was statistically more likely to be women (P < 0.001), unmarried (P < 0.001), living alone prestroke (P < 0.05), and unemployed (P < 0.001). Conclusion: Most older stroke patients can successfully complete a rehabilitation program and return to the community. Demographic, functional, and outcome differences were found when comparing this population with younger counterparts.