Should age be a deciding factor of selection for admission in a Rehabilitation Centre after Stroke?

Pedro Francisco dos Santos Caetano, José Vilaça, Inês Campos, Anabela Pereira, Jorge Laíns


Aims: Stroke represents one of the main causes of mobility and mortality, occurring in three-quarters of the elderly. Rehabilitation aims at improving deficits, function and social integration of patients with stroke sequelae. We characterized an elderly population admitted for post-stroke rehabilitation and evaluated the differences in the functional evolution between elderly and non-elderly patients.

Methods: We analyzed retrospectively all the patients suffering a stroke admitted in a Centre of Rehabilitation Medicine between June 1, 2014, and May 31, 2016. Patients were divided into 2 groups: elderly (65 years) and non-elderly (<65 years). The following variables were analyzed: sex, age, days of admission, post-discharge destination and Functional Independence Measure (FIM) at admission and discharge.

Results: We analyzed 134 patients with stroke. The majority were elderly with a mean age of 72.07±6.50. 51.3% were men and the number of days of admission was 107.4±59.5 (vs 109.50±55.7 days in the non-elderly group). 86.4% of these patients were discharged home. Comparing FIM mean values at admission and discharge, we found differences between these two groups, the elderly patients having lower FIM values at admission (75.75 vs 82.96 non-elderly; p=0.005) and at discharge (88.93 vs 99.12 non-elderly; p=0.005). There was also some difference in the FIM increase between admission and discharge in these groups. Despite not being statistically significant.

Conclusions: Most patients hospitalized were over 65 years old. FIM values at admission of the elderly patients are lower than of the non-elderly, probably because the latter present specific characteristics associated with the ageing process. Although FIM increases were lower in the elderly patients’ group, this difference was not significant whereby they appeared to have functionally benefited as much as the non-elderly. Therefore, age on its own does not appear to be a decision criteria for admission.


Stroke; Ageism; Rehabilitation Center.


Direcção-Geral da Saúde. Acidente vascular cerebral: itinerários clínicos. Lisboa: Lidel; 2010.

Nakayama H, Jørgensen HS, Raaschou HO, Olsen TS. The influence of age on stroke outcome. The Copenhagen Stroke Study. Stroke. 1994;25(4):808-13.

Kalra L. Does age affects benefits of stroke unit rehabilitation? Stroke. 1994; 25(2):346-51.

Secção de Medicina Física e de Reabilitação da Union Européenne dês Médices Spécialistes (UEMS). Académie Européene de Médecine de Réadaptation. European Board of Physical and Rehabilitation Medicine. Livro branco de medicina fìsica e de reabilitação na Europa. Coimbra;

The World Health Organization MONICA Project (monitoring trends and determinants in cardiovascular disease): a major international collaboration. WHO MONICA Project Principal Investigators. J Clin Epidemiol. 1988;41(2):105-14.

Ovbiagele B, Nguyen-Huynh MN. Stroke epidemiology: advancing our understanding of disease mechanism and therapy. Neurotherapeutics. 2011;8(3):319-29.

Amarenco P, Bogousslavsky J, Caplan LR, Donnan GA, Hennerici MG. Classification of stroke subtypes. Cerebrovasc Dis. 2009;27(5):493-501.

Ring H, Feder M, Schwartz J, Samuels G. Functional measures of first-stroke rehabilitation inpatients: usefulness of the Functional Independence Measure total score with a clinical rationale. Arch Phys Med Rehabil. 1997;78(6):630-5.

Paolucci S, Antonucci G, Grasso MG, Bragoni M, Coiro P, De Angelis D, Fusco FR, Morelli D, Venturiero V, Troisi E, Pratesi L. Functional outcome of ischemic and hemorrhagic stroke patients after inpatient rehabilitation: a matched comparison. Stroke. 2003; 34(12):2861-5.

Kissela B, Lindsell CJ, Kleindorfer D, Alwell K, Moomaw CJ, Woo D, Flaherty ML, Air E, Broderick J, Tsevat J. Clinical prediction of functional outcome after ischemic stroke: the surprising importance of periventricular white matter disease and race. Stroke. 2009;40(2):530-6.

Direção-Geral da Saúde. Acidente vascular cerebral: prescrição de medicina física e de reabilitação. Norma nº 054/2011 [Internet]. 2011 [capturado em 15 abr. 2019].

Disponível em:

The World Health Organization MONICA Project (monitoring trends and determinants in cardiovascular disease): a major international collaboration. WHO MONICA Project Principal Investigators. J Clin Epidemiol. 1988;41(2):105-14.

World Health Organization. Definition of an older or elderly person. Geneva: WHO; 2016.

Linacre JM, Heinemann JW, Wright BD, Granger CV, Hamilton BB. The structure and stability of the functional independence measure. Arch Phys Med Rehabil. 1994;75(2):127-32.

Instituto Nacional de Estatística. Causas de morte 2013 [Internet]. Lisboa: Instituto Nacional de Estatística; 2015 [capturado em 15 abr. 2019].

Disponível em:

Ingall T. Stroke: incidence, mortality, morbidity and risk. J Insur Med. 2004;36(2):143-52.

Saposnik G, Cote R, Phillips S, Gubitz G, Bayer N, Minuk J, Black S; Stroke Outcome Research Canada (SORCan) Working Group. Stroke outcome in those over 80: a multicenter cohort study across Canada. Stroke. 2008;39(8):2310-7.

Bagg S, Pombo AP, Hopman W. Effect of age on functional outcomes after stroke rehabilitation. Stroke. 2002;33(1):179-85.

Musuka TD, Wilton SB, Traboulsi M, Hill MD. Diagnosis and management of acute ischemic stroke: speed is critical. CMAJ. 2015;187(12):887-893.

Bernhardt J, Godecke E, Johnson L, Langhorne P. Early rehabilitation after stroke. Curr Opin Neurol. 2017;30(1):48-54.

Pettersen R, Dahl T, Wyller TB. Prediction of longterm functional outcome after stroke rehabilitation. Clin Rehabil. 2002;16(2):149-59.


ISSN-L: 2357-9641

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