COGNITIVE PERFORMANCES AND REHABILITATION OUTCOMES: FOCUS ON PATIENTS WITH COGNITIVE IMPAIRMENT. (11th November 2018)

• Record Type: Journal Article
• Authors: Mazzola, P; Merla, L; Guerini, V; Cappuccio, M; Bellelli, G; Annoni, G
• Is Part Of: Innovation in aging. Volume 2(2018)Supplement 1
• Page Start: 503
• Page End: 504
• Publication Date: 2018-11-11
• Subjects: Aging -- Periodicals; Gerontology -- Periodicals; 612.67
• DOI: 10.1093/geroni/igy023.1871
• Languages: English
• ISSNs: 2399-5300

Abstract

Abstract: Rehabilitation of frail elderly patients is challenging. In particular, subjects affected by cognitive impairment require an early and tailored rehabilitation treatment in order to obtain a functional gain that could be comparable to cognitively normal individuals. Our aim was to investigate the functional gain of a population of older patients divided according to their cognitive status. We collected retrospectively the medical charts of 207 patients aged ≥65 admitted to Fondazione Gusmini rehabilitation facility (Vertova, Italy) during an 18-month period (2015–2016). We collected data through a comprehensive geriatric assessment. Outcome measures were absolute functional gain (AFG=Barthel Index at discharge – upon admission), and rehabilitation efficiency index (REI=AFG/length of stay). We compared cognitively impaired subjects (Group 1 MMSE<24, N=83) with cognitively normal ones (Group 2 MMSE≥24, N=124). Mean age of the study population was 79.6 ± 7.6 years (71.5% females). Group 1 patients were on average more comorbid (CIRS-comorbidity 4.8 ± 1.5 vs. 3.6 ± 1.7, p<0.001) than those with normal cognition. Considering rehabilitation success for REI≥0.5, group 1 subjects reached a poorer efficiency than their counterparts did (44.6% vs. 80.6%, p<0.001). However, if the AFG is adjusted by the number of physiotherapy sessions rather than length of stay, group 1 patients reach rehabilitation efficiency in 61.4% of cases compared to the previous 44.6%. Patients with cognitive impairment can improve significantly after rehabilitation. The key aspect is to provide a tailored and intensive treatment, because the effectiveness of their rehabilitation phase is independently related to the number of training sessions rather than length of stay per se.