title: Ageism in stroke rehabilitation studies.
abstract: BACKGROUND
  stroke is predominantly a disease of older people. While age bias has been demonstrated in studies of pharmacological therapeutic interventions in stroke, the extent of discrimination by age in stroke rehabilitation studies is unknown. The aim of this study was to systematically review the literature to assess the extent of ageism in stroke rehabilitation studies.
  
  
  METHODS
  all randomised control trials (RCT) on stroke rehabilitation entered in the Cochrane database which reported mean age were included. Patient gender and exclusion criteria were also recorded.
  
  
  RESULTS
  of 241 RCT's identified, 182 were eligible for inclusion. The mean age of all patients was 64.3, almost a decade younger than those seen by stroke physicians in daily practice in global terms, and 11-12 years younger than encountered in hospital practice in the British Isles. Almost half (46%) of trials excluded patients with cognitive impairment, almost one-quarter (23%) patients with dysphasia and one-eighth (13%) excluded patients with multiple strokes.
  
  
  CONCLUSIONS
  we have identified a clear difference in the mean age of those included in stroke rehabilitation studies compared with the international mean age of stroke. In addition, a quarter of trials excluded dysphasic patients which may indicate omission of more severe strokes. This means that the evidence base for stroke rehabilitation is deficient in terms of matching the characteristics of patients encountered in clinical practice, and a more representative sample of older people and those with significant disability must be included in future trials.
authors.affiliation: Age Related Health Care, AMNCH, Tallaght Hospital Tallaght Dublin 24, Dublin 24, Ireland.
authors.forename: Eva Joan
authors.initials: EJ
authors.lastname: Gaynor
authors.forename: Sheena Elizabeth
authors.initials: SE
authors.lastname: Geoghegan
authors.forename: Desmond
authors.initials: D
authors.lastname: O'Neill
mesh_terms: D000368:Aged; D063506:Ageism / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D015983:Selection Bias; D020521:Stroke / Q000453:epidemiology; D000071939:Stroke Rehabilitation
keywords: ageism; older people; rehabilitation; stroke