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A prospective observational study of outcomes from rehabilitation of elderly patients with moderate to severe cognitive impairment

Title: A prospective observational study of outcomes from rehabilitation of elderly patients with moderate to severe cognitive impairment
Authors: Vassallo, M
Poynter, L
Kwan, J
Sharma, JC
Allen, SC
Item Type: Journal Article
Abstract: Objectives: To evaluate rehabilitation outcomes in patients with moderate to severe cognitive impairment. Design: Prospective observational cohort study. Setting: Rehabilitation unit for older people. Subjects: A total of 116 patients (70F) mean age (SD) 86.3 (6.4). Group 1: 89 patients with moderate cognitive impairment (Mini-Mental State Examination 11–20); and Group 2: 27 patients with severe cognitive impairment (Mini-Mental State Examination 0–10). Intervention: A personalised rehabilitation plan. Main measures: Barthel Activity of Daily Living score on admission and discharge, length of stay and discharge destination. Results: Of 116 patients, 64 (55.2%) showed an improvement in Barthel score. Mini-Mental State Examination was significantly higher in those who improved, 15.4 (SD 3.7) vs.13.2 (SD 5.1): p = 0.01. The mean Barthel score improved in both groups; Group 1 – 14.7 (SD 19.1) vs. Group 2 – 9.3 (SD 16.3): p = 0.17. Of 84 home admissions in Group 1, more patients returning home showed improvements of at least 5 points in the Barthel score compared with nursing/residential home discharges (32/37 – 86.5% vs. 10/28 – 35.7%: p = 0.0001). In Group 2 of 17 home admissions, 6/6 (100%) home discharges showed improvement compared with 3/7 (42.8%) discharges to nursing/residential home (p = 0.07). In Group 1, a discharge home was associated with significantly greater improvement in number of Barthel items than a nursing/residential home discharge (3.27 (SD 2.07) vs. 1.86 (SD 2.32): p = 0.007). A similar non-significant pattern was noted for severe cognitive impairment patients (3.5 (3.06) vs. 1.14 (1.06); p = 0.1). Conclusion: Patients with moderate to severe cognitive impairment demonstrated significant improvements in Barthel score and Barthel items showing that such patients can and do improve with rehabilitation.
Issue Date: 1-Sep-2016
Date of Acceptance: 19-Sep-2015
URI: http://hdl.handle.net/10044/1/85258
DOI: 10.1177/0269215515611466
ISSN: 0269-2155
Publisher: SAGE Publications
Start Page: 901
End Page: 908
Journal / Book Title: Clinical Rehabilitation
Volume: 30
Issue: 9
Copyright Statement: © The Author(s) 2015. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Keywords: Science & Technology
Life Sciences & Biomedicine
Rehabilitation
Activities of daily living
Barthel
cognitive impairment
elderly
barriers to rehabilitation
HIP FRACTURE
DEMENTIA
CARE
HOME
Activities of daily living
Barthel
barriers to rehabilitation
cognitive impairment
elderly
Activities of Daily Living
Age Factors
Aged
Aged, 80 and over
Cognitive Dysfunction
Female
Hospitalization
Humans
Male
Neuropsychological Tests
Prospective Studies
Treatment Outcome
Humans
Treatment Outcome
Hospitalization
Activities of Daily Living
Prospective Studies
Neuropsychological Tests
Age Factors
Aged
Aged, 80 and over
Female
Male
Cognitive Dysfunction
Science & Technology
Life Sciences & Biomedicine
Rehabilitation
Activities of daily living
Barthel
cognitive impairment
elderly
barriers to rehabilitation
HIP FRACTURE
DEMENTIA
CARE
HOME
Rehabilitation
11 Medical and Health Sciences
Publication Status: Published
Online Publication Date: 2016-08-04
Appears in Collections:Department of Brain Sciences



This item is licensed under a Creative Commons License Creative Commons