Predictors of improved functional outcome in elderly inpatients after rehabilitation: a retrospective study
Open accessAbstract
PURPOSE: The number of elderly inpatients has been steadily increasing worldwide. However, the ability to predict the degree of improvement of functional capacity after comprehensive examination of elderly inpatients is still lacking. The purpose of this study was to investigate the predictors of improved functional outcome after rehabilitation of elderly inpatients. METHODS: We performed a retrospective cohort study with 1,079 patients (age <70 years: N=331, age ≥70 years: N=748) who had been admitted to Tottori Municipal Hospital. Functional Independence Measure (FIM) scores were measured both at admission and discharge to calculate FIM gain and efficiency. Of these patients, 262 patients had oral examinations on admission. The Mann-Whitney U-test or chi-square test was used for statistical analyses. Conditional logistic regression analysis was used to compute the odds ratio (OR) and 95% confidence interval (CI). Cut-off values of FIM scores to determine if elderly inpatients were able to return home after discharge were determined using a receiver operating characteristic curve. RESULTS: FIM scores, including FIM gain and efficiency, of elderly patients were significantly lower than those of middle-aged patients. Inability to close the lips and dysfunctional tongue movement, but not the loss of teeth, were correlated with a reduced improvement of FIM scores. Cognitive impairment and aspiration pneumonia, but not cerebrovascular disease, were also correlated with a reduced improvement of FIM scores. Interestingly, FIM scores were significantly lower in patients with both cerebrovascular disease and a loss of posterior occlusion. Factors shown to have a significant impact on the improvement of FIM scores included the stable posterior occlusion (OR: 2.23, 95% CI: 1.2-4.1), closed lips (OR: 5.15, 95% CI: 2.3-11.7), functional tongue movement (OR: 5.74, 95% CI: 3.0-11.0), presence of cognitive impairment (OR: 0.31, 95% CI: 0.17-0.49), and presence of aspiration pneumonia (OR: 0.27, 95% CI: 0.15-0.51). CONCLUSION: Age and disorder of oral function may be significant predictors of improved functional capacity after rehabilitation for elderly inpatients.
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- Authors
- Naruishi, K., Kunita, A., Kubo, K., Nagata, T., Takashiba, S., & Adachi, S.
- Affiliations
- Okayama University Hospital (JP)
- Tottori Municipal Hospital (JP)
- Tokushima University (JP)
- Okayama University (JP)
- Corresponding author
- Naruishi, Koji
- Venue
- Clinical Interventions in Aging
- Publisher
- Informa UK Limited
- Published
- 2014-12
- Volume
- 9
- Pages
- 2133
- ISSN
- 1176-9092 (ISSN-L)
- 1178-1998
- PMC
- PMC4264602
- OpenAlex
- W1969701633
- Cited by
- 20
- References
- 23
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 1 · 2022: 3 · 2021: 2 · 2018: 4 · 2017: 5 · 2016: 2 · 2015: 1
- FWCI
- 5.98
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Clinical Interventions in Aging (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Institutional Repositories DataBase (IRDB) (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- hospitalized older adults, functional outcome, rehabilitation, Functional Independence Measure, predictors of functional recovery, oral function, posterior occlusion, lip closure, tongue movement, cognitive impairment, aspiration pneumonia, cerebrovascular disease
- MeSH terms
- Aged, Aged, 80 and over, Cerebrovascular Disorders, Female, Health Status Indicators, Humans, Male, Middle Aged, Patient Admission, Patient Discharge, Retrospective Studies, Cohort Studies, Geriatric Assessment, Logistic Models, Treatment Outcome, Outcome Assessment, Health Care, Recovery of Function
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