The validity of FIM as a predictor of functional independence of stroke patients: A comparison between the early and late elderly

[Purpose] This study examined the validity of admission FIM scores as predictors of functional independence, of "early" and "late" elderly patients with stroke in a post-acute rehabilitation unit. [Subjects] After excluding stroke patients with recurrence and complications, the remaining 286 (150 males and 136 females) patients aged 65 to 84 with stays of more than one month. [Methods] According to the level of ADL independence, based on motor and cognitive admission FIM scores, the patients were divided into 3 groups: completely dependent/maximal assistance; moderate/minimal assistance; and supervision/completely independent. Subsequently, time-dependent changes in FIM scores were analyzed to compare the "early" and "late" elderly, score-based groups, and measurements. [Results] Total motor and cognitive FIM scores on and after admission did not overlap among the three ADL independence groups, and showed linear time-dependent changes. Such changes were not observed in individual FIM item, while differences were shown in the period and degree of ADL improvement between the age-based groups. [Conclusion] Motor and cognitive FIM scores were shown to be valid as predictors of functional independence, regardless of age. Scores of individual items were shown to be generally inappropriate as predictors. As the period and degree of ADL improvement varied between the age-based groups, it may be important to continuously provide approaches not only for motor, but also cognitive functions over a long period of time, while considering the age and type of ADL, as well as the individual needs of each patient.