STROKE INPATIENT REHABILITATION - A COMPARISON ACROSS AGE-GROUPS

Objective: To examine and compare the inpatient stroke rehabilitation experience of older adults (greater-than-or-equal-to 75 years) with th at of young adults (< 65 years) and young-old adults (65-74 years). De sign: Cross-sectional descriptive study. Setting: A large university-a ffiliated free-standing rehabilitation hospital. Participants: 260 adu lts who were admitted to inpatient stroke rehabilitation with a primar y diagnosis of recent (< 120 days) stroke (ICD9 430-436). Variables: D emographic data, diagnosis, time between stroke onset and rehabilitati on admission, discharge disposition, and functional status on admissio n and discharge were obtained from the patient's medical record. Treat ment intensity and type, length of stay, and primary payment source da ta were obtained from the patient's billing record. Three-month mortal ity data were available from the hospital's routine follow-up survey. Main Results: Compared with the younger adults (< 65 yrs and 65-75 yea rs), the older adults (greater-than-or-equal-to 75 years) were admitte d to rehabilitation earlier and with comparable cognitive but poorer m otor function. Rehabilitation treatment intensity (per day) and type w ere similar across age groups, but the older adults (greater-than-or-e qual-to 75 years) had significantly shorter rehabilitation stays. Thre e-month survival was comparable across age groups, but the older adult s (greater-than-or-equal-to 75 years) had poorer motor function at dis charge and were more often discharged to a nursing home or required a paid caregiver. Conclusions: Age-associated factors may influence inpa tient stroke rehabilitation referral, treatment, and outcome, particul arly for patients over age 75. The cumulative effects of frailty and c o-morbid disease upon stroke disability and treatment are possible exp lanations for the findings. The study provides evidence of a need for further investigation of stroke rehabilitation strategies for adults o ver 75 years old.