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Neuropsychiatric symptoms are common after stroke and are distressing symptoms. They may persist after the acute event and negatively impact rehabilitation, functioning, and patients' quality of life. To elucidate the prevalence and course of neuropsychiatric symptoms in stroke patients during rehabilitation, we prospectively investigated the trajectory change of neuropsychiatric symptoms and the association between these symptoms and functional recovery. This observational study enrolled 204 stroke patients consecutively admitted to the rehabilitation ward. We administered the Neuropsychiatric Inventory-Nursing Home Version (NPI-NH) for evaluating the neuropsychiatric symptoms (e.g., apathy and depression) and the Functional Independence Measure (FIM) and Montebello Rehabilitation Factor Score (MRFS) for functional recovery. The cumulative prevalence of neuropsychiatric symptoms was 48% during hospitalization; depression, anxiety, and sleep disturbances were most frequent. Binomial logistic regression analyses revealed that the factors associated with deterioration of neuropsychiatric symptoms during hospitalization included premorbid depression (odds ratio: 18.628, P =.001), the length of stay from onset to rehabilitation ward admission (odds ratio: 1.022, P =.012), motor FIM at admission (odds ratio: 0.950, P <.001), and NPI-NH at admission (odds ratio: 0.923, P =.011). Stepwise multiple regression analyses revealed that the NPI-NH at admission was associated with the MRFS (β = −0.128, P =.037). Neuropsychiatric symptoms are common in stroke patients undergoing rehabilitation and have a substantially negative impact on rehabilitation outcomes. Stroke patients with prolonged acute-phase hospitalization and low functioning at admission must be monitored to detect any deterioration in the neuropsychiatric state. [ABSTRACT FROM AUTHOR]

Aim: This study investigated changes in functional status in home‐dwelling stroke survivors 1–3 years after inpatient rehabilitation. It also examined the factors associated with longitudinal functional changes and health‐related quality of life. Methods: Survey evaluations were conducted at the homes of 27 stroke survivors. The Functional Independence Measure (FIM), Short Form 36, Frenchay Activities Index, and Hamilton Depression Rating Scale were used to assess functional status, quality of life, social activity, and depression symptoms, respectively. Results: From the time of discharge to follow‐up (mean: 2.1 ± 0.6 years), total FIM and motor FIM scores were mildly improved, and cognitive FIM score was significantly improved. On the Short Form 36, physical functioning, general health, and vitality scores were lower than norm‐based scores. Multiple regression analyses showed a positive association between change in motor FIM score and Frenchay Activities Index score and a negative association between change in cognitive FIM score and elapsed time after discharge. With regard to health‐related quality of life, motor FIM score was associated with the physical component summary, whereas age and Hamilton Depression Rating Scale score were associated with the mental component summary. Conclusion: Social participation was associated with long‐term improvement in activities of daily living, indicating that interventions targeting social function are important for maintaining and further improving activities of daily living in stroke survivors. Health‐related quality of life was correlated with activities of daily living and depression; therefore, interventions targeting these parameters are important in improving the quality of life of stroke survivors. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to determine the predictive factors for functional recovery and home discharge in stroke patients receiving in-hospital rehabilitation. Methods: This study included a consecutive series of 174 stroke patients (average age 73.0 ± 10.8) admitted to the convalescent rehabilitation ward at Azumino Red Cross Hospital in Japan after acute rehabilitation. The main outcome measures were functional recovery (functional independence measure [FIM] at discharge and Montebello rehabilitation factor score [MRFS]) and home discharge. Results: Total FIM improved from 72.6 ± 27.6 to 87.7 ± 29.9 during the hospital stay ( P < 0.001). The average MRFS was 0.30 ± 0.28. Of the 174 patients, 151 were discharged home (87%). Age, stroke type, premorbid independence, motor FIM, and cognitive FIM at admission showed a significant association with FIM at discharge, while age, premorbid independence, motor FIM at admission, and cognitive FIM at admission were statistically significant predictors of MRFS. Female sex, not living with family, premorbid independence, and neglect were negatively associated with home discharge. Conclusions: Premorbid disability and cognitive dysfunction at admission were both negatively associated with functional recovery and home discharge in patients undergoing inpatient stroke rehabilitation. Geriatr Gerontol Int 2012; 12: 215-222. [ABSTRACT FROM AUTHOR]