Abstract
OBJECTIVE: This study investigated cognitive functioning among older adults with physical debility not attributable to an acute injury or neurological condition who were receiving subacute inpatient physical rehabilitation. DESIGN: A cohort investigation with assessments at admission and discharge. SETTING: Three geriatric rehabilitation hospital wards. PARTICIPANTS: Consecutive rehabilitation admissions (n = 814) following acute hospitalization (study criteria excluded orthopaedic, neurological, or amputation admissions). INTERVENTION: Usual rehabilitation care. MEASUREMENTS: The Functional Independence Measure (FIM) Cognitive and Motor items. RESULTS: A total of 704 (86.5%) participants (mean age = 76.5 years) completed both assessments. Significant improvement in FIM Cognitive items (Z-score range 3.93-8.74, all P < 0.001) and FIM Cognitive total score (Z-score = 9.12, P < 0.001) occurred, in addition to improvement in FIM Motor performance. A moderate positive correlation existed between change in Motor and Cognitive scores (Spearman's rho = 0.41). Generalized linear modelling indicated that better cognition at admission (coefficient = 0.398, P < 0.001) and younger age (coefficient = -0.280, P < 0.001) were predictive of improvement in Motor performance. Younger age (coefficient = -0.049, P < 0.001) was predictive of improvement in FIM Cognitive score. CONCLUSIONS: Improvement in cognitive functioning was observed in addition to motor function improvement among this population. Causal links cannot be drawn without further research.