Fifty consecutive patients aged 60 years or older admitted to an inpatient rehabilitation program were studied to determine whether demographic, cognitive, affective, and awareness of deficit data had predictive value in determining performance-based Instrumental Activity of Daily Living (IADL) capacity. Correlational and hierarchical regression analysis found that cognition, awareness of deficit, and years of education accounted for 70% of IADL variance. Of particular note, cognition contributed unique variance above and beyond that accounted for by demographic variables. Additionally, the Awareness Interview (AI) contributed unique variance above and beyond that accounted for by demographic and cognitive variables. This study provides support for the assessment of cognitive functioning and awareness of deficit in rehabilitation settings to assist in outcome prediction.
To cross validate and extend the authors' finding that cognition is one of the best predictors of return to living alone after medical rehabilitation. Design: A prospective sample of live-alone older medical rehabilitation patients followed from admission to discharge. Logistic regression identified significant predictors of return to living alone, and measures of predictive power were calculated. Setting: Stroke and geriatric units of a free-standing urban medical rehabilitation hospital. Participants: One hundred ninety-four older consecutively admitted medical rehabilitation patients 60 years old or older. Main Outcome Measure: Return to living alone versus discharge to living with others. Results: Consistent with the authors' original findings, both cognition and self-care motor skills were significant predictors of return to living alone. Cognition acted as a suppressor variable, leading to age and education effects only when entered into the regression equation. New variables did not add significantly to prediction. Conclusion: The value of rehabilitation psychologists' role in making cognition-based recommendations about discharge disposition in live-alone older adults is supported by findings from this study.
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