Age and the Rehabilitative Care of Stroke

Abstract

Over a nine‐year period, 1,223 patients with cerebrovascular accidents were admitted to Montebello State Hospital, a chronic disease institution. The findings of this study consistently reflect an adverse influence of rising age on the response of CVA patients to rehabilitation. The older patients (over 65) were more disabled on admission, improved less often while in the hospital and died more often than the younger patients. However, the better response of the younger patients did not reduce their length of stay in the hospital (21–23 weeks). It would be unfair for clinicians to reject for rehabilitation all older patients because of these disadvantages, since our adjustment analysis has shown one way (number of hospital‐weeks of care required to obtain a living and improved patient) in which priorities can be balanced for different age groups. It would be premature, however, to apply these figures widely until larger groups of patients are studied in different rehabilitation centers. This can be done quickly if it is agreed that scientific rather than intuitive guidelines for selecting patients deserve urgent attention.

Stroke Inpatient Rehabilitation: A Comparison across Age Groups

“…Although older age is generally associated with poorer rehabilitation admission and discharge functional status." 10,24,25 in our study lower admission and discharge motor indices were specific to the oldest group of adults. The oldest adults may have more severe functional limitations with stroke, less physiologic reserve available for recovery, and a high prevalence of co-morbid conditions, particularly cognitive impairments.…”