Clinical characteristics and functional outcome of stroke patients 75 years old and older.

OBJECTIVE

To examine the demographic and clinical characteristics of stroke patients 75 years old and older admitted for rehabilitation, to study medical complications that occurred during rehabilitation, and to document functional outcome and possible factors influencing outcome.

DESIGN AND SETTING

A case series of 59 consecutive inpatients admitted to a rehabilitation facility with confirmed strokes over a 2-year period.

MEASURES

Patients were selected by rehabilitation physicians for admission into the rehabilitation program. Measures for outcome include the Modified Barthel Index (MBI) and the patient's discharge disposition.

RESULTS

The mean age of this cohort was 80.4+/-3.2 years, and mean lengths of stay in the acute and rehabilitation facilities were 15.2 and 37.4 days. Twelve patients had three or more medical illnesses; hypertension and diabetes were the most common. Cognitive impairment, urinary incontinence, and dysphagia requiring tube feeding were present in 45.1%, 33.9%, and 11.9% of patients, respectively. Nineteen patients (32.2%) developed medical complications, and urinary tract infection was the most common. Improvements in functional status, motor power, continence, and dysphagia were noted after rehabilitation. Fifty-three patients (89.8%) were successfully discharged home, 28.8% of whom employed domestic maids as caregivers. The discharge MBI score was strongly predicted by the admission MBI and cognition scores.

CONCLUSION

Despite their age, significant functional improvements were documented in this cohort of aged stroke patients, and the majority were discharged home. Admission MBI and cognition scores strongly predicted functional outcome.