title: [Early geriatric rehabilitation: an opportunity for the oldest old].
abstract: BACKGROUND
  Physicians in Germany who are not specialized in geriatric medicine often have to make decisions regarding referral of patients for early geriatric rehabilitation. The risk of inadequate patient allocation is due to lack of knowledge or underestimation of the potential benefit of early rehabilitation in reducing a patient's need of care. Particularly the oldest old are affected by those inadequate decisions.
  
  
  METHODS
  Based on the nationwide database Gemidas Pro, the data sets of ≥ 90-year-old patients were analysed regarding diagnoses, multimorbidity, gender, length of stay, procedures, outcome parameters as nursing personnel regulation (PPR), Barthel index and the Timed Up and Go (TUG) test compared to younger age groups. Data from 85 acute inpatient geriatric institutions during the period from January 2006 to December 2009 were included.
  
  
  RESULTS
  Neither the analysis of the diagnosis nor multimorbidity showed relevant differences compared to younger patients. Despite poorer functional status at admission, the ≥ 90 year olds experienced a 25 % increase in the activities of daily living (ADL) measured by PPR, 30 % increase in mobility classification based on the TUG and 59 % increase in ADL measured with the Barthel index. These changes were significantly different. In addition, the length of stay was 18.96 days on average in the group of ≥ 90-year-old patients, which was but not significantly shorter than the length of stay in the group of 70- to 79-year-old (19.7 days) and 80- to 89-year-old patients (19.65 days).
  
  
  CONCLUSIONS
  The analyses show that the oldest old suffer from more severe deficits in functional status on admission in acute geriatric wards compared to younger patient groups. However, on discharge the oldest old show a significant and relevant increase in mobility and ADL without increase in length of stay.
authors.affiliation: Klinik für Geriatrie, Universitätsklinikum Jena, Bachstr. 18, 07743, Jena, Deutschland, anja.kwetkat@med.uni-jena.de.
authors.forename: A
authors.initials: A
authors.lastname: Kwetkat
authors.forename: T
authors.initials: T
authors.lastname: Lehmann
authors.forename: A
authors.initials: A
authors.lastname: Wittrich
mesh_terms: D000203:Activities of Daily Living; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000453:epidemiology* / Q000534:rehabilitation*; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D006299:Health Services for the Aged / Q000706:statistics & numerical data; D049690:History, Ancient; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data*; D051346:Mobility Limitation; D020127:Recovery of Function; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D017678:Sex Distribution; D016896:Treatment Outcome