Department of Rehabilitation Sciences, King Saud University, Riyadh.
Comprehensive Rehabilitation Care Department, Rehabilitation Hospital, King Fahad Medical City, Riyadh, Saudi Arabia.
Clin Interv Aging. 2017 Oct 24;12:1791-1797. doi: 10.2147/CIA.S145402. eCollection 2017.
Among various risk factors, age has been identified as a nonmodifiable risk factor for stroke that influences functional outcomes after inpatient stroke rehabilitation in the developed world as well as in Saudi Arabia (SA). The demand for inpatient stroke rehabilitation services increases with population aging and stroke incidence; however, these services are limited in SA.
To examine functional outcomes by age after inpatient stroke rehabilitation in SA.
Data from 418 patients with stroke who underwent inpatient stroke rehabilitation at the King Fahad Medical City-Rehabilitation Hospital, Riyadh, SA, between November 2008 and December 2014 were collected from electronic medical records. According to the patients' age, we classified participants into two groups: adults, aged <65 years (n=255), and older adults, aged ≥65 years (n=163). All patients' functional statuses at admission and discharge from inpatient stroke rehabilitation were assessed using the functional independence measure (FIM) scale.
The mean age was 59.9 years (SD =9.4). Older adults had significantly smaller changes in functional outcome from admission to discharge on both the total FIM (23 [SD =15.9]) and the motor FIM (21 [SD =15.4]), and they were significantly less independent (36%) compared to adults. In the adjusted models, older adults had significantly lower scores than adults, by 11 points (<0.0001) for the total FIM score and by 10 points (<0.0001) for the motor FIM subscale score. There was no significant change with age in the cognitive FIM subscale score.
After inpatient stroke rehabilitation, older adults had limited functional outcomes or were less independent than adults. However, the clinical relevance of this finding is questionable, so there is currently no justification to deny patients access to intensive stroke rehabilitation solely because of advanced age. Future large-scale research is needed to confirm rehabilitation outcomes by including confounders such as social support, socioeconomics, comorbidities, and the patient's opinion after rehabilitation.
在各种风险因素中，年龄被确定为影响发达国家和沙特阿拉伯（SA）住院卒中康复后功能结局的不可改变的风险因素。随着人口老龄化和卒中发病率的增加，对住院卒中康复服务的需求增加；然而，这些服务在 SA 是有限的。
检查 SA 住院卒中康复后按年龄划分的功能结局。
从 2008 年 11 月至 2014 年 12 月在 SA 利雅得的法赫德国王医疗城康复医院接受住院卒中康复的 418 例卒中患者的电子病历中收集数据。根据患者的年龄，我们将参与者分为两组：成年人，年龄<65 岁（n=255）和老年人，年龄≥65 岁（n=163）。所有患者在入院和出院时的功能状态均使用功能独立性测量（FIM）量表进行评估。
平均年龄为 59.9 岁（SD=9.4）。老年人在从入院到出院的整个 FIM（23[SD=15.9]）和运动 FIM（21[SD=15.4]）的功能结局方面的变化明显较小，与成年人相比，他们的独立性明显较小（36%）。在调整后的模型中，老年人的总 FIM 评分和运动 FIM 亚量表评分均显著低于成年人，分别低 11 分（<0.0001）和 10 分（<0.0001）。认知 FIM 亚量表评分与年龄无显著变化。
在住院卒中康复后，老年人的功能结局有限或独立性低于成年人。然而，这一发现的临床意义值得怀疑，因此目前没有理由仅仅因为年龄较大而拒绝患者接受强化卒中康复。未来需要进行大规模研究，通过纳入社会支持、社会经济学、合并症和康复后患者的意见等混杂因素，来确认康复结果。
