Stroke Rehabilitation—Is Age a Determinant?†

Adler, Mark K.; Brown, Curtland C.; Acton, Patricia

doi:10.1111/j.1532-5415.1980.tb01129.x

Cited by 23 publications

(7 citation statements)

References 2 publications

(2 reference statements)

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“…Previous surveys evaluating the influence of age on stroke outcome were based on study samples encompassing between 300 and 500 patients, 1,25,26 and most included Ͻ200 patients. [27][28][29] Our rate of patients lost to follow-up (21.4%) is similar to those previously reported in studies on stroke outcome. 25,30 The chance of being lost to follow-up was higher among younger than older patients (mean age, 72.6Ϯ12.1 years in followed versus 69.2Ϯ13.8 in lost patients; PϽ0.001) and in those without major neurological deficits after stroke such as coma or paralysis.…”

Section: Discussionsupporting

confidence: 79%

Stroke in the Very Old

Carlo

Lamassa

Pracucci

et al. 1999

Stroke

209

105

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Background and Purpose-The oldest old represent the fastest-growing segment of the elderly population in developed countries. Knowledge of age-specific aspects of stroke is essential to establish diagnostic and therapeutic pathways and to set up prevention and rehabilitation programs. We sought to evaluate stroke features and functional outcome in patients aged Ն80 years compared with the younger age groups. Methods-In a European Union Concerted Action involving 7 countries, 4499 patients hospitalized for first-in-a-lifetime stroke were evaluated for demographics, risk factors, clinical presentation, resource use, and 3-month disability (Barthel Index) and handicap (Rankin Scale). Results-Overall, 3141 patients (69.8%) were aged Ͻ80 years, and 1358 (30.2%) were aged Ն80 years. At baseline, female sex, prestroke institutionalization, and a worse prestroke Rankin score were significantly more frequent in the older patients, as were coma, paralysis, swallowing problems, and urinary incontinence in the acute phase (all P values Ͻ0.001). Brain imaging and other diagnostic tools were significantly less used in the older patients. Paralysis, swallowing problems, and incontinence during hospitalization independently predicted 3-month disability or handicap in both groups. For the older patients, prestroke institutionalization proved a further strong and independent determinant of 3-month disability (odds ratio, 2.33; 95% CI, 1.22 to 4.45) and handicap (odds ratio, 7.04; 95% CI, 1.62 to 30.69). Conclusions-In the very old, both medical and sociodemographic factors may significantly influence stroke outcome, showing peculiar characteristics. Knowledge of these determinants may reduce the burden on health systems, improving quality of care.

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Section: Discussionsupporting

confidence: 79%

Stroke in the Very Old

Carlo

Lamassa

Pracucci

et al. 1999

Stroke

209

105

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“…Age of the subject is of particular interest as several other studies have linked age to functional evaluation scores (Jongbloed, 1986;Oczkowski & Barreca, 1993). It has also been suggested that older people have lower initial functional scores (Adler, Brown & Acton, 1980;Wade et al, 1983). Wade et al proposed that comorbidity related to age may reduce a person's functional ability prestroke, thereby lowering their poststroke potential.…”

Section: Discussionmentioning

confidence: 99%

The Rivermead Perceptual Assessment Battery: Can it predict functional performance?

Donnelly

2002

Aus Occup Therapy J

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One of the major concerns of occupational therapy for people who have had a stroke is the functional consequence of impairment. The current study investigated the relationship between client test performance on the Rivermead Perceptual Assessment Battery (RPAB) and functional performance at admission and discharge from rehabilitation, as measured by the Functional Independence Measure (FIM SM instrument). The two aims of the study were: (i) to determine if a relationship exists between the RPAB and functional performance; and (ii) to ascertain if the RPAB could predict discharge functional performance. Forty-six adults were assessed by the RPAB and the FIM SM over an 18-month period. The multiple regression technique, backward elimination was used to address the research questions. The results indicated that no relationship exists between the RPAB and functional performance on admission to rehabilitation. However, the presence or absence of a visual perceptual disorder as indicated on the RPAB, combined with FIM SM admission scores were significant in predicting FIM SM discharge scores. A client's age was found to be as predictive of functional performance as the RPAB, requiring far less time and effort to administer and include in the predictive equation. Results also indicate that people with a visual perceptual problem, as assessed by the RPAB, will achieve significantly lower scores on the FIM SM at discharge from rehabilitation than people without a visual perceptual disorder. The use of the RPAB as an assessment tool and its predictive abilities are discussed in light of the findings of this study.

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“…Age has been shown to be no deterrent to rehabilitation or recovery (Andrews et al 1982, Adler et al 1980. Because it is a concept rather than a technique, there is no absolute prescription which would suit every patient.…”

Section: March 2000 Pat Davies Switzerlandmentioning

confidence: 99%

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Davies¹

2000

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Stroke Rehabilitation—Is Age a Determinant?†

Cited by 23 publications

References 2 publications

Stroke in the Very Old

Stroke in the Very Old

The Rivermead Perceptual Assessment Battery: Can it predict functional performance?

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