Original studyPredictive Role of Single Diseases and Their Combination on Recovery of Balance and Gait in Disabled Elderly Patients
Section snippets
Admission Criteria and Selection of Patients
Among 1134 consecutive elderly patients first admitted to the 35-bed Geriatric Evaluation and Rehabilitation Unit (GERU - Richiedei Medical Center, Palazzolo s/O - Brescia, Italy), between August 2001 and June 2003, we selected 710 patients (62.6% of total).
All patients were affected by osteoarthritis or stroke or Parkinson’s disease with severe balance and gait disorder (Tinetti–gait and balance score less than or equal to 18/28) and underwent a rehabilitative treatment (45 min/d, 6 days a
Results
The main characteristics of the study population are shown in Table 1. Patients were most frequently female, with a moderate-to-severe impairment in activities of daily living and a high risk of falling (mean Tinetti score 13.6 ± 8.5). Nutritional and inflammatory biomarkers were in the normal range. Patients had a high level of somatic comorbidity having (about) 5 diseases, and taking 5 drugs.
A negative prediction of functional recovery was expressed by the “more disabling” diseases group. The
Discussion
It is widely recognized that comorbidity has a negative effect on physical function that goes beyond the sum of the effect of the single diseases. Indeed, in older comorbid patients, the causal relationship between single conditions and disability may be not linear.12 There are consistent evidences that combination of diseases influencing physical function, may be detrimental on physical decline.8 But they may operate through a different mechanism. These findings demonstrate that comorbidity of
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