[Short-term rehabilitation of Parkinson's disease patients delays nursing home placement].
OBJECTIVE
To evaluate the efficacy of the Groningen Parkinson Short-Stay (GPSS) treatment, a short-term and intensive clinical intervention, on delaying the definitive nursing home placement of patients with Parkinson's disease.


METHODS
Retrospective cohort study.


METHODS
We included 65 patients with Parkinson's disease, of whom 39 were men and 26 were women with a mean age of 72 years (range: 43-88), who in 2009 were admitted to the GPSS ward of nursing home Maartenshof in Groningen, the Netherlands, for six weeks. The primary outcome measure was the number of patients who were able to live independently at home after discharge. The secondary outcome measures were changes in medication, change in cognitive performance and the duration of being able to live independently at home.


RESULTS
After treatment on the GPSS ward, 49 patients could return home. Patients with a Mini-Mental State Examination (MMSE) score < 26 showed a significant increase of 2.5 points (14%, p = 0.003) after treatment. The frontal lobe functions, measured with the Frontal Assessment Battery, showed a significant increase of 1.3 points (11%, p = 0.024). In 31 (76%) patients, the dopaminergic medication was underdosed; after increasing the dosage, the clinical symptoms improved. In 10 (53%) psychotic patients, the dosage of atypical antipsychotics was increased. After an average follow-up period of 16.5 months (range: 10.0-24.5), 38 patients (63%) were still living at home.


CONCLUSIONS
Treatment at the GPSS ward postpones a definitive nursing home placement. An important factor in this is the optimisation of medication for motor, behavioural and cognitive functioning. This treatment should be used more widely for patients in the end stages of Parkinson's disease.
Afd. Neurologie, UMCG, Groningen, the Netherlands. t.steendam@umcg.nl
T Elien
TE
Steendam-Oldekamp
A W F Wijnand
AW
Rutgers
Eric
E
Buskens
Teus
T
van Laar
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003071:Cognition / Q000187:drug effects / Q000502:physiology; D015331:Cohort Studies; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010300:Parkinson Disease / Q000523:psychology* / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
D000978:Antiparkinson Agents; D014150:Antipsychotic Agents