Outcomes for older adults in inpatient specialist neurorehabilitation

Inpatient specialist neurorehabilitation in the United Kingdom is based on providing a service to "working-age" adults (<65 years), with little evidence for outcomes for older adults involved with these services.

The aim of this study is to determine any difference in outcome after inpatient neurorehabilitation between younger and older adults assessed as having rehabilitation potential.

A two-centre retrospective review was performed comparing patients aged<65 and≥65 years by diagnostic group in terms of length of stay, changes in UK Functional Independence Measure+Functional Assessment Measure (UK FIM+FAM) scores and discharge destination.

Six hundred and sixteen patients (32%≥65 years) were included. The 2 age groups did not differ in length of stay (median difference 7 days, 95% confidence interval [CI] -2 to 15, P=0.112), but both UK FIM+FAM change and efficiency were higher for the older than younger group (median difference 7, 95% CI 2-13, P=0.006 and 0.10, 0.01-0.19, P=0.031 respectively). Older age was associated with discharge to long-term care (6%<65 years; 11%≥65 years, x²=4.10, P=0.043). Results and trends were similar in patients with acquired brain injury (n=429), spinal cord injury (n=59) and peripheral neuropathy (n=34) but not progressive neurological disorders (n=70).

Older adults considered to have rehabilitation potential may have greater functional gains from inpatient specialist inpatient rehabilitation than younger adults. Age alone should not exclude admission to inpatient specialist neurorehabilitation.