Article

OBJECTIVE: To explore the influence of level of functioning and cognitive status
on outcome after rehabilitation for older people with different types of
impairment. DESIGN: An inception cohort study. SUBJECTS: A total of 560 older
people, mean age 80.0 years, participating in rehabilitation programmes in the
Sydney area. METHODS:
Level of functioning using the Functional Independence
Measure (FIMTM), the Barthel Index, cognitive status using the Mini Mental State
Examination (MMSE), and type of impairment were assessed on admission. Level of
functioning and length of hospital stay were assessed on discharge and after 6
months. RESULTS: Disability on admission was the strongest independent predictor
for functioning at discharge (B=0.35, R2=0.49 p<0.001) and follow-up (B=0.22,
R2=0.27, p<0.001), and for length of hospital stay (B= -0.63, R2=0.12, p<0.001).
Cognitive status at admission (mean MMSE 25 (standard deviation 5.3)) was also a
significant predictor of functioning at discharge and at follow-up (B=0.30,
R2=0.42, p<0.01). Functional status prior to injury, joint replacement impairment
category, and type of hospital had marginal, but statistically significant,
impacts on functioning after discharge. CONCLUSION: Functional status on
admission to a rehabilitation facility has stronger predictive value than type of
impairment for rehabilitation outcome for older people. Cognitive impairment may
have a small adverse effect on rehabilitation outcome.

Langue : ANGLAIS