Inflammation, pressure ulcers and poor functional status predict negative rehabilitation outcomes in postacute geriatric patients.

The purposes of this retrospective study were to document the prevalence of serum C-reactive protein (CRP), a biomarker of inflammation, and its potential predictive value for Rehabilitation outcomes in post-acute elderly inpatients. The medical records of 304 elderly subjects admitted to our Rehabilitation Institute for any disease following an acute event were examined. High levels of CRP (> 0.5 mg/dl) were present in 100% of the subjects, and the value > 1.5 mg/dl (n = 86) predicted unfavourable outcomes (n = 28; 32.5% of the patients: death or transfer to other institutions). Among the patients with favourable outcomes (discharge home n = 255), 62.7% still exhibited severe disabilities. Pressure ulcers and low functional status also predicted unfavourable outcomes. The study highlights the need for future investigations into the possible reduction of CRP levels, after an intensive nutritional approach and combined physical interventions.

Study of respiratory function in the elderly with different nutritional and cognitive status and functional ability assessed by plethysmographic and spirometric parameters.

From a sample of 265 elderly subjects (age 80.2 +/- 6.8 years) admitted to a geriatric care unit, free from cardiac and respiratory diseases, with normal chest X-ray and gas analysis, 53 subjects were selected and their respiratory functions (assessed by spirometric parameters and airway resistance 'Raw') were studied to correlate them with nutritional status, cognitive impairment, independence in everyday life activities and mood disorders, assessed, respectively, by the Mini Nutritional Assessment, rapid Mini Mental State test (MMSr), activities of daily living (ADL), instrumental activities of daily living (IADL) evaluation, Barthel Index and Cornell Depression Scale. The enrolled subjects were able to perform normally a forced expiration, although most of them committed errors in this test, according to the American Thoracic Society (ATS) criteria. Thus, about 32% started at lung volume0.12 s); in 62% of the subjects expiration time was too short and in 58% the terminal plateau was <2 s. Nevertheless, the spirometric parameters (and Raw) were considered normal. Forced vital capacity and peak expiratory flow (but not FEV1) were higher in the subjects without disability, while cognitive and nutritional status did not seem to have any influence on spirometric performance; MMSr score was related to compliance with ATS criteria for acceptability of the forced manoeuvre; mental and mood disorders, nutritional conditions and disability did not seem to have any influence on error rates. Our data show that our geriatric enrolled patients were able to perform an imperfect, often unfinished, but acceptable forced expiration; dynamic index values were related to disability, while the errors in starting the test were related to the mental conditions.