The association between patients' cognitive status and rehabilitation outcome in a geriatric day hospital.
OBJECTIVE
To assess whether and to what extent cognitive status affects functional gain in mobility and extended activities of daily living (ADL) in patients admitted to a geriatric day hospital.


METHODS
During 2003, 135 older patients admitted to a rehabilitation day hospital were evaluated by the Mini Mental State Examination (MMSE) and the Cognitive Functional Independence Measure (FIM). On admission and at discharge, they were assessed by the Nottingham Extended ADL Index (NEAI) and the Timed Get Up and Go test (TUG).


RESULTS
Orthopedic and stroke patients achieved significant functional gain in mobility regardless of their cognitive status. Nevertheless, cognitively intact stroke patients achieved higher admission and discharge NEAI scores, manifesting greater absolute functional gain than cognitively impaired patients. The patients' ability to extract their rehabilitation potential was significantly better.


CONCLUSIONS
Cognitively impaired patients can improve in mobility and performance of extended ADL during day hospital rehabilitation. Evaluation of the patients' cognitive status may enable the multidisciplinary team to develop suitable individual programs and better allocate resources. Cognitively intact stroke patients may benefit from extended rehabilitation treatment compared to impaired stroke patients as they are more capable of utilizing their potential to achieve independence in daily tasks.
Hershkovitz
Avital
A
'Beit Rivka' Geriatric Rehabilitation Center, Petach Tikva, and Sackler School of Medicine, Tel Aviv University, Israel. avitalhe@clalit.org.il
Brill
Shai
S
D000368:Aged; D003071:Cognition / Q000502:physiology*; D003631:Day Care, Medical; D004185:Disability Evaluation; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D007557:Israel; D008297:Male; D009140:Musculoskeletal Diseases / Q000503:physiopathology / Q000534:rehabilitation*; D009483:Neuropsychological Tests; D017063:Outcome Assessment, Health Care; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation