Harada Akio, Kawai Nobuyuki, Ogawa Tomoya, Hatakeyama Tetsuhiro, Tamiya Takashi
Department of Neurological Surgery, Faculty of Medicine, Kagawa University.
Department of Neurological Surgery, Kagawa Rehabilitation Hospital.
Acta Med Okayama. 2021 Aug;75(4):479-486. doi: 10.18926/AMO/62400.
Instances of traumatic brain injury (TBI) in the elderly have been increasing along with the aging of popula-tions. In the present study, we examined the effect of aging on long-term multidisciplinary in-patient rehabili-tation efficacy after TBI. Sixty-three patients with physical and cognitive impairments after TBI were enrolled in this study. Patients were divided into 4 age groups (≤ 24, 25-44, 45-64, ≥ 65 years) and the clinical charac-teristics and rehabilitation efficacy of each age group were determined. Functional disability was evaluated using motor and cognitive Functional Independence Measure (FIM) scores. Rehabilitation efficacy was assessed by FIM gains during rehabilitation and compared among the groups. There were no statistically significant dif-ferences in motor and cognitive FIM gains among the age groups. However, cognitive FIM gain was limited in a subset of ≥ 65 patients, and initial cognitive measures could not predict cognitive FIM improvement. These results indicate that chronological age is insufficient to accurately predict rehabilitation efficacy in older TBI patients, and that such patients should be considered candidates for intensive rehabilitation programs based on these results. Accurate prognostication of rehabilitation efficacy with continuing data collection is important when using rehabilitation resources for older TBI patients.
随着人口老龄化,老年创伤性脑损伤(TBI)的病例数一直在增加。在本研究中,我们研究了年龄对TBI后长期多学科住院康复疗效的影响。本研究纳入了63例TBI后有身体和认知障碍的患者。患者被分为4个年龄组(≤24岁、25 - 44岁、45 - 64岁、≥65岁),并确定了每个年龄组的临床特征和康复疗效。使用运动和认知功能独立性测量(FIM)评分评估功能残疾情况。通过康复期间的FIM改善情况评估康复疗效,并在各年龄组之间进行比较。各年龄组在运动和认知FIM改善方面无统计学显著差异。然而,≥65岁患者亚组的认知FIM改善有限,且初始认知测量无法预测认知FIM的改善情况。这些结果表明,实足年龄不足以准确预测老年TBI患者的康复疗效,基于这些结果,此类患者应被视为强化康复计划的候选对象。在为老年TBI患者使用康复资源时,持续收集数据以准确预测康复疗效非常重要。