Outcomes for older adults in inpatient specialist neurorehabilitation.

Background: Inpatient specialist neurorehabilitation in the United Kingdom is based on providing a service to "working-age" adults (<65 years), with little evidence for outcomes for older adults involved with these services.

Objective: The aim of this study is to determine any difference in outcome after inpatient neurorehabilitation between younger and older adults assessed as having rehabilitation potential.

Methods: A two-centre retrospective review was performed comparing patients aged<65 and≥65 years by diagnostic group in terms of length of stay, changes in UK Functional Independence Measure+Functional Assessment Measure (UK FIM+FAM) scores and discharge destination.

Results: Six hundred and sixteen patients (32%≥65 years) were included. The 2 age groups did not differ in length of stay (median difference 7 days, 95% confidence interval [CI] -2 to 15, P=0.112), but both UK FIM+FAM change and efficiency were higher for the older than younger group (median difference 7, 95% CI 2-13, P=0.006 and 0.10, 0.01-0.19, P=0.031 respectively). Older age was associated with discharge to long-term care (6%<65 years; 11%≥65 years, x=4.10, P=0.043). Results and trends were similar in patients with acquired brain injury (n=429), spinal cord injury (n=59) and peripheral neuropathy (n=34) but not progressive neurological disorders (n=70).

Conclusion: Older adults considered to have rehabilitation potential may have greater functional gains from inpatient specialist inpatient rehabilitation than younger adults. Age alone should not exclude admission to inpatient specialist neurorehabilitation.