Does age predict outcome in stroke rehabilitation? A study of 878 Chinese subjects

Abstract

Background: The predicting value of age on stroke rehabilitation has been controversial. There is a lack of large scale studies in Chinese population to examine the effect of age on stroke rehabilitation. Methods: This retrospective cohort study includes stroke patients receiving standard inpatient multidisciplinary rehabilitation program in a neurorehabilitation ward of a convalescence hospital in Hong Kong. Functional Independence Measure (FIM) ≥90 was used to define a good outcome. Results: 878 subjects with 471 (53.6%) men and 407 (46.4%) women were studied. There were important differences in clinical characteristics and complications of stroke among patients of 3 age groups: <65 years, ≥65 years and <80 years, and ≥80 years. The total FIM scores both on admission and at discharge were lower in the older age groups. No significant difference was observed in the changes of FIM scores across these age groups (1-way ANOVA, P = 0.067). Age was not an independent predictor for a good outcome. FIM upon admission was an independent predictor for good outcome in all patients and in individual age groups. Having employment before stroke was a predictor for good outcome in all patients. Living at home prior to stroke was a predictor for the total population, and the ≥65 and <80 years group. The length of stay predicted a good outcome in the ≥80 years group. Conclusion: As older patients show comparable improvement during rehabilitation, intensive rehabilitation should not be withheld in stroke patients simply because of advanced age.