Rehabilitation outcomes in elderly stroke patients aged 85 and above

Background: Intensive inpatient rehabilitation is well known to have positive impacts on functional recovery of patients who sustained stroke. However, there is limited understanding of its effectiveness in elderly patients, particularly those over 85. This entity faces unique challenges due to age-related factors and potential exclusion from intensive rehabilitation. Therefore, a comprehensive understanding of how rehabilitation impacts elderly patients is required. Methods: In order to consolidate current understanding regarding the effectiveness of stroke rehabilitation in the oldest-old (85+) patients, a literature search was conducted to gather all available evidence studying rehabilitation outcome measures in the over-85 age group. Results: A limited number of literatures addressed the impact of stroke rehabilitation on the oldest-old group of patients. Outcome measures used to assess the effectiveness of inpatient rehabilitation included Functional Independence Measure (FIM), Barthel Index (BI), Rivermead Mobility Index (RMI) and Dysphagia Outcome and Severity Score (DOSS). These measures collectively showed significant improvement in function at discharge compared to admission across all age group. A general trend of reduced functional gain in the older age group was observed, although the statistical significance of the difference between younger and older patients varied. Conclusion: Although the effectiveness of stroke rehabilitation is reduced in patients aged over 85, the functional gains achieved by these patients remains invaluable across all age groups. Therefore, stroke rehabilitation should be provided to the oldest-old patients without discrimination.