Intermediate care as a means of improving mental status in post-acute elderly patients

To evaluate the impact of residential intermediate care (IC) on the cognitive status of post-acute older patients and its correlation with the improvement in physical independence.

This prospective observational study involved 299 subjects (116 males and 183 females; mean age 80.1 ± 8.3 years) transferred to IC. The Mini Mental State Examination (MMSE) and a panel of laboratory and functional parameters were evaluated upon admission to IC (T0) and at the time of discharge (T1). The functional evaluations included the Cumulative Illness Rating Scale, the Barthel Index (BI) and the Morse Fall Scale (MFS). Afterwards, the patients were grouped on the basis of their MMSE score at T1: those with an unchanged or worse MMSE score (group A) and those with a better MMSE score (group B). The laboratory and functional parameters of the two groups were then compared.

There was a significant improvement between T0 and T1 in the MMSE score (18.1 ± 7.5 vs 19.6 ± 7.3, P < 0.001) and the BI (42.1 ± 27.7 vs 53.6 ± 30.0, P < 0.001), as well as brain natriuretic peptide, C-reactive protein and blood glucose levels. Group B had a significantly better BI (57.7 ± 29.1 vs 47.2 ± 31.5, P = 0.003) and a slightly better MFS. There was a close relation between the MMSE scores and BI.

Residential IC is a type of rehabilitation that favourably affects the cognitive status and physical independence of older post-acute patients.