Rehabilitation outcome of elderly patients after a first stroke: effect of cognitive status at admission on the functional outcome
| Autor: | Mark Dolgopiat, Ayala Lusky, Vita Barell, Raphael J. Heruti, Haim Ring, Shalom Levenkrohn, Rachel Dankner, Abraham Adunsky |
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| Rok vydání: | 2002 |
| Předmět: |
Male
medicine.medical_specialty Activities of daily living Geriatric rehabilitation medicine.medical_treatment Psychological intervention Physical Therapy Sports Therapy and Rehabilitation Neuropsychological Tests Patient Care Planning Activities of Daily Living medicine Humans Prospective Studies Israel Prospective cohort study Stroke Aged Rehabilitation Health Care Rationing Stroke Rehabilitation Cognition Middle Aged medicine.disease Treatment Outcome Physical therapy Female Psychology Cognition Disorders Cognitive appraisal |
| Zdroj: | Archives of physical medicine and rehabilitation. 83(6) |
| ISSN: | 0003-9993 |
| Popis: | To assess whether, and to what extent, cognitive outcome relates to overall functional outcome among elderly stroke patients.Nonconcurrent prospective study.Geriatric rehabilitation division at a large, urban, academic, freestanding hospital in Israel.Three hundred thirty-six patients aged 60 years and older admitted consecutively for rehabilitation after first acute stroke. Inclusion criteria were met by 315 patients, who were included in the final analysis. Average age was 75.3 years. The stroke was right sided in 44.1%.Not applicable.The motor subscale of the FIM instrument assessed functional status. Absolute functional gain was determined by the FIM motor gain. Relative functional gain was calculated according to the Montebello Rehabilitation Factor Score. Cognitive status was assessed with the Mini-Mental State Examination (MMSE) and the FIM cognitive subscale.FIM scores increased significantly during rehabilitation, mainly due to improvement in motor functioning. A strong association was found between the cognitive scales (r=.853, P.001). Better rehabilitation outcomes were observed in patients with higher admission cognitive status, adjusting for the effect of age, sex, onset to admission interval, length of stay, and severity of stroke (odds ratio = 2.0; 95% confidence interval, 1.5-2.5).Impaired cognitive status at admission negatively affects the rehabilitation outcome of elderly stroke patients. The utility of routinely using a cognitive test for all patients before admission to rehabilitation, preferably the MMSE, is emphasized. The time, cost, and effort involved in performing such a test are negligible, and the potential benefits are considerable. |
| Databáze: | OpenAIRE |
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