047The Effectiveness of Stroke Rehabilitation in Older Old Patients Compared to a Group of Younger Stroke Patients

Abstract

Background: The benefits of rehabilitation post stroke are widely accepted. However, the older old (patients over 80) are underrepresented in previous studies. We aimed to examine whether the benefits differ based on age. Method: All patients admitted to a specialist inpatient rehabilitation hospital post stroke between 2010-2016 were included. Patients were assessed for rehabilitation potential prior to transfer and received an individualised interdisciplinary rehabilitation programme. Admission and discharge Barthel scores were recorded. We analysed the change in Barthel index (BI) and length of stay (LOS) by age group. Results: 185 patients were included, 10 of these were excluded due to death, becoming unwell and self-discharge. Patients (47% men, mean age 77.8, 83% ischaemic strokes) were generally previously independent (81% modified Rankin 0-1). 32.6% of patients admitted for rehabilitation showed no evidence of cognitive impairment, 29.1% had mild cognitive impairment, 22.9% moderate cognitive impairment and 11.4% severe cognitive impairment. Mean increase in Barthel did not differ across the age groups and there was no significant difference in LOS. For all age groups, the mean BI on admission was 13 (4.7 SD), 15.6 on discharge (4.34 SD) with a mean LOS of 82 days. In the under 65's (n = 13), the mean BI on admission was 13.8 (6.1 SD), 16.1 (4.9 SD) on discharge with a mean LOS of 78 days (70 SD). Over 85 s (n = 35), mean BI on admission 11(4.2 SD), 13.3 (4.8 SD) on discharge, LOS 89 days (67 SD).The mean change in BI was 2.9 for the 76-85 group and 2.3 for other age groups. p values for BI change and LOS trends across age groups were non-significant. 81% of patients were discharged home. Conclusion: Stroke rehabilitation can be as effective in older old people as in younger people. Age should not be a barrier to access rehabilitation and selection criteria should be the same as their younger counterparts.