Perspectives of inpatient neurological rehabilitation in elderly patients

Demographic data record an increasing number of people aged over 65 years, with specific health conditions and a high probability to suffer from chronic diseases, cognitive impairment or loss of autonomy, and with limited functional reserve. The prevalence of disability increases with age, affecting 33% of men and 42% of women aged over 85 years. Many neurodegenerative disorders increase in prevalence with age. Thus, the need for rehabilitation treatment in this segment of population is very high, loss of functioning being the most prominent condition for admitting elderly persons in rehabilitation facilities. Rehabilitation in the elderly is an important tool in regaining autonomy, associated with substantial reduction in the burden of health and social costs. Patients aged over 80 years need a comprehensive geriatric assessment (CGA) to establish the global capabilities of the person for inclusion in a coordinated therapy plan and a long term follow-up. CGA will identify patients with severe or complicated medical conditions and important disability who require a multidisciplinary team and a coordinated rehabilitation program, accessible only in rehabilitation hospitals. Rehabilitation treatment should start from the intensive care unit, and continues until the patient reaches a plateau of maximal functional improvement. The most useful therapeutic interventions in old people are physical and occupational therapy, and, for selected and stable patients, therapy in a balnear resort is an option to improve their quality of life. Key words: geriatric population, rehabilitation, loss of autonomy, old patients