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Defining rehabilitation success in older adults with dementia–results from an inpatient geriatric rehabilitation unit

The journal of nutrition, health & aging volume 20, pages 439–445 (2016)Cite this article

Abstract

Objective

To quantify the magnitude of functional recovery in older adults with and without dementia admitted to an inpatient geriatric rehabilitation program by measuring change in measures of global physical function and physical therapy treatment outcomes.

Design

Retrospective cohort study.

Setting

Rehabilitation academic hospital.

Participants

Consecutive subjects, with (N=65, age 81.9±6.0 y) and without (N=157, age 82.8±7.2 y) a dementia diagnosis, had assessment data at admission and discharge from inpatient geriatric rehabilitation unit.

Interventions

Not applicable.

Measurements

The Functional Independence Measure (FIM) was used to estimate level of independence on activities of daily living. The Berg Balance Scale (BBS), Timed Up & Go Test (TUG) and 2 Minute Walk Test (2MWT) were used to estimate functional mobility and endurance. The FIM (total, motor subscale, cognitive subscale scores) were used to calculate rehabilitation efficacy and efficiency scores.

Results

After controlling for confounding, there was no group difference for gains on the BBS, TUG, 2MWT; there was no group difference on rehabilitation efficacy and efficiency values based on the FIM motor subscale. The magnitude of the rehabilitation gain using the total FIM score was statistically different between groups, people with dementia having smaller gains.

Conclusion

Older adults with a diagnosis of dementia are capable of making motor function recovery during inpatient sub-acute rehabilitation comparable to their peers without a dementia diagnosis. The metric used to evaluate functional recovery influences the determination of rehabilitation success between groups. Rehabilitation success should be defined among people with a dementia diagnosis by a change in the motor subscale of the FIM, rather than the total FIM score or the gain relative to the maximal FIM score.

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Author information

Affiliations

  1. School of Physical Therapy, University of Western Ontario, London, Ontario, Canada

    Susan W. Muir-Hunter

  2. Gait and Brain Lab, Parkwood Hospital, London, Ontario, Canada

    Susan W. Muir-Hunter, G. Lim Fat & M. Montero-Odasso

  3. Division of Geriatric Medicine, University of Western Ontario, London, Ontario, Canada

    R. Mackenzie, J. Wells & M. Montero-Odasso

Authors
  1. Susan W. Muir-Hunter
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  2. G. Lim Fat
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  3. R. Mackenzie
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  4. J. Wells
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  5. M. Montero-Odasso
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Corresponding author

Correspondence to Susan W. Muir-Hunter.

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Muir-Hunter, S.W., Lim Fat, G., Mackenzie, R. et al. Defining rehabilitation success in older adults with dementia–results from an inpatient geriatric rehabilitation unit. J Nutr Health Aging 20, 439–445 (2016). https://doi.org/10.1007/s12603-015-0585-x

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  • DOI: https://doi.org/10.1007/s12603-015-0585-x

Key words

  • Aged
  • rehabilitation
  • dementia