Geriatric Rehabilitation Clinic Research Articles

ANTIDEMENTIA DRUGS IN A GERIATRIC CLINIC

Many patients in a geriatric clinic have cognitive deficits. Therefore the use of antidementia drugs there should be high. Moreover the situation might have changed over the past years. The study was done in a geriatric acute care and rehabilitation clinic with a big outpatient memory department. Most people come after falls or fractures, after surgery or with cardiovascular disease. The clinic orders the drugs through a central pharmacy which registers the number of pills delivered to the clinic. If possible the clinic usually continues prehospital medication. In 2017 1,239 patients were analyzed. The mean age was 82.4±7.1 years. The MMSE of these patients on admission was 24.7±4.8 points. On admission 46.4% had a MMSE of 27 to 30 points, 39.1% a MMSE of 20 to 26, 13.2% from 10 to 19 and only 1.4% a MMSE below 10 points. In 2017 516,745 pills were ordered through the central pharmacy, 1,612 of which were antidementia drugs. Therefore only 0.31% of all drugs used in 2017 were antidementia medication. The number even slightly decreased over the past years from 2,011 in 2007 to 1,692 in 2012 and finally to 1,612 in 2017. In 2017 donepezil was odered most often in 38.2% of the orders, rivastigmin in 19.9%, galantamine in 6.9%, memantine in 31.3% and others in 3.7%. This pattern had changed over the years. In 2007 rivastigmin was used in 72.9% of the orders, donepezil only in 12.2% and memantine in 9.0%. About 50% of the patients in the clinic had cognitive deficits with a MMSE of 26 points or lower. Despite that only 0.3% of the drugs ordered were antidementia drugs. This did not change much over the past 10 years or even decreased. Therefore antidementia medication seems to be not important in a geriatric clinic. The reasons for that are discussed.

Status of Geriatrics in 22 Countries.

The aim of this article is to describe the current status of geriatrics and position of geriatricians in 22 countries of three continents, and to portray their attitudes towards and resources allocated to geriatrics. An electronic survey was delivered to a convenience sample of 22 geriatricians in leading positions of their countries. The time required in post graduation specialist training to become a geriatrician varied from one year (subspecialty in the USA) to six years (independent specialty in Belgium). The number in the population aged 80+ per geriatrician varied from 450 (Austria) to 25,000 (Turkey). Of respondents, 55% reported that geriatrics is not a popular specialty in their country. Acute geriatric wards, rehabilitation and outpatient clinics were the most common working places for geriatricians. Nearly half of the respondents had an opinion that older patients who were acutely ill, were receiving subacute rehabilitation or had dementia should be cared for by geriatricians whereas half of the respondents would place geriatricians also in charge of nursing home and orthogeriatric patients. The biggest problems affecting older people's clinical care in their countries were: lack of geriatric knowledge, lack of geriatricians, and attitudes towards older people. Half of respondents thought that older people's health promotion and comprehensive geriatric assessment were not well implemented in their countries, although a majority felt that they could promote good geriatric care in their present position as a geriatrician. The position of geriatric, geriatricians' training and contents of work has wide international variety.

Fall risk as a function of time after admission to sub-acute geriatric hospital units.

BackgroundThere is evidence about time-dependent fracture rates in different settings and situations. Lacking are data about underlying time-dependent fall risk patterns. The objective of the study was to analyse fall rates as a function of time after admission to sub-acute hospital units and to evaluate the time-dependent impact of clinical factors at baseline on fall risk.MethodsThis retrospective cohort study used data of 5,255 patients admitted to sub-acute units in a geriatric rehabilitation clinic in Germany between 2010 and 2014. Falls, personal characteristics and functional status at admission were extracted from the hospital information system. The rehabilitation stay was divided in 3-day time-intervals. The fall rate was calculated for each time-interval in all patients combined and in subgroups of patients. To analyse the influence of covariates on fall risk over time multivariate negative binomial regression models were applied for each of 5 time-intervals.ResultsThe overall fall rate was 10.2 falls/1,000 person-days with highest fall risks during the first week and decreasing risks within the following weeks. A particularly pronounced risk pattern with high fall risks during the first days and decreasing risks thereafter was observed in men, disoriented people, and people with a low functional status or impaired cognition. In disoriented patients, for example, the fall rate decreased from 24.6 falls/1,000 person-days in day 2–4 to about 13 falls/1,000 person-days 2 weeks later. The incidence rate ratio of baseline characteristics changed also over time.ConclusionsFall risk differs considerably over time during sub-acute hospitalisation. The strongest association between time and fall risk was observed in functionally limited patients with high risks during the first days after admission and declining risks thereafter. This should be considered in the planning and application of fall prevention measures.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-016-0346-7) contains supplementary material, which is available to authorized users.

Effect of course length and corridor width on the 2-minute walk test performance in geriatric patients

Objective: To evaluate the effect of course length and corridor width on 2-minute walk test results in older adults. Design: Cross-sectional and experimental study with different test conditions. Setting: Geriatric rehabilitation clinic. Subjects: A total of 21 patients (median age 81 years). Main measures: Patients walked two minutes on a 20 m and 40 m course with a 2 m or 1 m corridor width and on a continuous course without any turning in a corridor of 2 m width, five walks in total. The distance traveled within the 2 minutes was recorded. Results: Compared with the 20 m course length, median walking distances measured by the 2-minute walk test in a walk way 2 m broad were better on the continuous corridor without any turn (136.9 m vs. 129.3 m, p = 0.002) and on the 40 m course (131.8 m vs. 129.3 m, p = 0.003). Walking distance on a 20 m course length was longer in a corridor of 2 m width compared with the 1 m corridor width (129.3 m vs. 119.2 m, p = 0.005). The walking distance was not affected by corridor width on the 40 m course length. Conclusions: Performance of elderly patients on the 2-minute walk test is influenced by the width of the corridor and the length of the course used.

ACCURACY OF 24-HR FOOD-REGISTRY METHOD IN ELDERLY SUBJECTS: ROLE OF A SURROGATE RESPONDENT

Importance: There are problems in the dietary assessment of elders due to the aging process. Objective: To assess the comparativity of dietary diversity reported by an elder with that reported independently by his/her Caregiver. Design: Comparison of foods consumed by elder in the previous 24-h reported by elder and caregiver. Outcome variable: % of foods reported and unreported by either. Setting: A Housing Development Unit, and a Geriatric Rehabilitation Clinic. Participants: 26 elders of 65-94 years of age, plus 26 caregivers. Results: The %foods unreported was more than double in elders than in caregiver (37% vs 17%). Regression models using sociodemographic variables of elders and caregivers as predictor variables showed only one significant variable [Caregiver cooked for the elder] associated with %unreported by caregiver and with %reported by either. No association with age, sex, being next-of-kin, schooling, cognitive level or setting was observed. Conclusion: The use of surrogates in dietary evaluation of elders should be carried out using the person in charge of preparing foods for the elder.

Validity of linear encoder measurement of sit-to-stand performance power in older people

ObjectiveTo investigate construct validity of linear encoder measurement of sit-to-stand performance power in older people by showing associations with relevant functional performance and physiological parameters. DesignCross-sectional study. SettingMovement laboratory of a geriatric rehabilitation clinic. ParticipantsEighty-eight community-dwelling, cognitively unimpaired older women (mean age 78 years). Main outcome measuresSit-to-stand performance power and leg power were assessed using a linear encoder and the Nottingham Power Rig, respectively. Gait speed was measured on an instrumented walkway. Maximum quadriceps and hand grip strength were assessed using dynamometers. Mid-thigh muscle cross-sectional area of both legs was measured using magnetic resonance imaging. ResultsAssociations of sit-to-stand performance power with power assessed by the Nottingham Power Rig, maximum gait speed and muscle cross-sectional area were r=0.646, r=0.536 and r=0.514, respectively. A linear regression model explained 50% of the variance in sit-to-stand performance power including muscle cross-sectional area (p=0.001), maximum gait speed (p=0.002), and power assessed by the Nottingham Power Rig (p=0.006). ConclusionsConstruct validity of linear encoder measurement of sit-to-stand power was shown at functional level and morphological level for older women. This measure could be used in routine clinical practice as well as in large-scale studies. Clinical Trial Registration NumberDRKS00003622.

Influence of living situation on vulnerable elderly: focus on nutritional status.

We compared the nutritional status of elderly people living in two different settings (shared-housing arrangements and home-living arrangements). For this secondary analysis, a cross-sectional study was performed. For the home-living setting, home-dwelling elderly people from Hamburg, Germany who were participants in a prior study were included. For the shared-housing arrangements (SHA) setting, we used baseline data from the WGQual Study. The sample from the home-living setting comprised patients who were discharged from a geriatric rehabilitation clinic within the six months prior to data collection. The sample from the shared-housing arrangements comprised all residents that lived in SHAs. Nutritional status was examined by administering the Mini Nutritional Assessment (MNA). Cognitive status was measured by the Mini Mental State Examination (MMSE). Overall, 142 individuals participated in this study. Statistical analysis showed differences in both overall MNA scores and MNA assessment scores. Significantly more participants from the SHA setting were at risk of malnutrition compared to the home-living setting. Screening and assessment of nutritional status and prevention interventions should be considered in SHA settings.

Long term functional status and quality of life in elderly people with mobility impairments

Background: In order to target effective interventions for elderly people with mobility impairments, health care professionals should be aware of the long term outcomes in this population. Objective: The aim of this study was to assess long term functional status and quality of life in elderly people post clinical stay in a geriatric rehabilitation clinic. Methods: We used a prospective longitudinal design. The study participants were elderly patients who had been admitted to a geriatric clinic. Data were collected at admission, at discharge (after 3 weeks), 6 months, 1 year, 3 years, and 4 years follow-up. Functional status was measured using the Barthel-Index (BI). Quality of life was measured using the WHOQEL-BREF. Independent variables were demographic characteristics as well as cognitive impairment, nutritional status and self-efficacy. Descriptive statistics and generalized linear models were used for statistical analysis. Results: Functional status as well as overall quality of life increased from admission to 6 months but decreased at 12 months follow-up. Results after 3 and 4 years differ from baseline. Discussion: There is a need for interventions to maintain and facilitate functional status and quality of life. Health care professionals should be aware of sex differences when planning intervention measures. Conclusion: Health care professionals should be aware of sex differences when planning intervention measures.

Assessing physical activity in inpatient rehabilitation—sensor-based validation of the PAIR

Increased physical activity is positively associated with better health in community-dwelling older persons. It is unclear whether physical activity also influences success of inpatient rehabilitation. For the assessment of physical activity in inpatient rehabilitation the Physical Activity in Inpatient Rehabilitation Assessment (PAIR), a short questionnaire based on five questions, was developed and preliminary validated. In this study, the PAIR was validated against a sensor-based physical activity measurement. Seventy functionally impaired and cognitively mostly intact patients of a German geriatric inpatient rehabilitation clinic who had undergone hip surgery (n = 62 women, median age = 83 years) participated. Physical activity was measured using the PAIR and a sensor-based activity monitor (Physilog ®; BioAGM, CH). Assessments were conducted at admission (T1) and 2 weeks later (T2) during the rehabilitation process. To assess concurrent and predictive validity, Spearman correlations and linear regression models were calculated using sensor-based walking activity and uptime activity (walking and standing time) as dependent variables. Criterion-related concurrent validity using physical activity sensors was weak to moderate. Correlations were slightly higher at T2 (r = 0.45-0.53) than at T1 (r = 0.44-0.46). The objectively measured variance of physical activity, explained by the PAIR, ranged from 25 to 43 %. PAIR activity scores and sensor-based walking or total activity increased in a dose-dependent manner, confirming the scoring system of the PAIR. The application time was usually less than 2 min. The validity of the PAIR is weak to moderate when compared to a sensor-based activity monitor and comparable to existing physical activity assessments for community-dwelling older adults.

Quantitative Description of the Lie-to-Sit-to-Stand-to-Walk Transfer by a Single Body-Fixed Sensor

Sufficient capacity and quality of performance of complex movement patterns during daily activity, such as standing up from a bed, is a prerequisite for independent living and also may be an indicator of fall risk. Until now, the transfer from lying-to-sit-to-stand-to-walk (LSSW) was investigated by functional testing, subjective rating or for activity classification of subtasks. The aim of this study was to use a single body-fixed inertial sensor to describe the complex movement of the LSSW transfer. Fifteen older patients of a geriatric rehabilitation clinic (median age 81 years) and ten young, healthy persons (median age 37 years) were instructed to stand up from bed in a continuous movement and to start walking. Data acquisition was performed using an inertial measurement unit worn on the lower back. Parameters extracted from the sensor outputs were able to correctly classify the subjects into a correct group with sensitivity and specificity between 90% and 100%. ICCs 3,1 of the descriptive parameters ranged between 0.85 and 0.95 in the cohort of older patients. The different strategies adopted to transfer from lying to standing up were estimated through an extended Kalman filter. The results obtained in this study suggest the usability of the instrumented LSSW test in clinical settings.

Aufbau und Ergebnisse einer geriatrischen Medikamentendatenbank

The aim of this project was to obtain information about drug therapy in geriatric units. Members of the geriatrics in Bavaria database (GiB-DAT) collected data on discharge medication and transferred them to the database. A total of 88,840 data sets of geriatric rehabilitation clinics and acute geriatric units were evaluated according to the anatomical therapeutic chemical (ATC) system. Patients (mean age: 81.1 years, female 67.7%) had an average of 10.4 diagnoses and took 8.0 drugs at discharge. A peak number of prescribed drugs was reached at the age of 60-70 years with a decrease in the following decades of life. Female patients received more drugs, significantly those in the decades from 71 to 80 and 81 to 90 years old. The bulk of the drugs were from the ATC groups "Cardiovascular system" (89.9%), "Nervous system" (82.3%) and "Alimentary tract and metabolism" (78%).

Urinary retention in older patients in connection with hip fracture surgery

The aim of this study was to examine the presence of urinary retention in older patients with hip fracture and to describe what actions nurses performed to detect, prevent and treat urinary retention. The incidence of urinary retention in patients with hip fracture is described as being as high as 82% before surgery and 56% after. Urinary retention is traditionally treated with an indwelling urethral catheter or intermittent catheterisation. Urinary retention and treatment with an indwelling urethral catheter are associated with high risks. A prospective, descriptive study. The study included 48 patients, 65 years or older who were recovering from hip fracture and receiving hospital care at a geriatric rehabilitation clinic. Six months before the study, a programme for the early detection, prevention and treatment of urinary retention was implemented. The presence of urinary retention, bacteriuria, the patient's cognitive function, use of ultra-sound bladder scan and type of treatment whether the patient suffered from urinary retention were examined during the study period. Urinary retention was found in 18 (38%) of the patients. No patients were examined using ultrasound bladder scan according to the programme, and the mean time of indwelling urethral catheter was three times longer than the programme suggested. The patients who were treated with intermittent catheterisation had had voiding satisfaction earlier and had not had repeated urinary retention compared to patients with indwelling urethral catheter. In most patients, the programme was not followed and urinary retention was commonly present. There is knowledge on how to reduce the presence of urinary retention, but the great challenge is how to implement this knowledge.

Does functional change predict the course of improvement in geriatric inpatient rehabilitation?

Objective: The evaluation of rehabilitation success as measured by different tools is becoming increasingly important in terms of time and money allocation. We wanted to know whether functional change in the first week predicts subsequent improvement in a geriatric inpatient rehabilitation clinic. Design: Observational longitudinal study. Setting: Geriatric inpatient rehabilitation clinic in Germany. Subjects: One hundred and sixty-one inpatients (117 women) with a median age of 82 years, capable of walking at baseline. Main measures: Weekly assessments of physical function were performed from admission until three weeks later. We used a self-rated tool (the function component of the Short Form — Late Life Function and Disability Index), a proxy-rated tool (the Barthel Index) and a performance-based tool (gait speed). We set up linear regression models to estimate the predictive capacity of change in physical function within the first week on change in physical function within the following two weeks. Results: Positive correlations were found between functional change within the first week and total change within three weeks. However, correlations of the same periods of change with subsequent change were negative. Correlations were highly significant for both analysis with P-values <0.0001 when the same measures for prediction and outcome were used. Correlations were inconsistent when prediction and outcome were different. Conclusions: Improvement within the first week of inpatient rehabilitation is negatively correlated with subsequent functional change.

Home rehabilitation after hip fracture. A randomized controlled study on balance confidence, physical function and everyday activities

Objective: To investigate whether home rehabilitation can improve balance confidence, physical function and daily activity level compared to conventional care in the early phase after hip fracture. Design: A randomized controlled study. Setting: Geriatric rehabilitation clinic. Subjects: One hundred and two community-dwelling elderly people. Interventions: A geriatric, multiprofessional home rehabilitation programme focused on supported discharge, independence in daily activities, and enhancing physical activity and confidence in performing daily activities was compared with conventional care in which no structured rehabilitation after discharge was included. Main measures: Falls efficacy, degree of dependency and frequency in daily activities, habitual physical activity and basic functional performance. Results: When comparing status one month after discharge with baseline, the home rehabilitation group showed a higher degree of recovery in self-care (P<0.0001), mobility (P = 0.002), locomotion (P = 0.0036) and domestic activities (P = 0.0098), as well as larger increase in balance confidence on stairs (P = 0.0018) and instrumental activities (mean increase home rehabilitation 19.7 and conventional care 7.1, P<0.0001) compared with the conventional care group. At one month, a majority of the home rehabilitation participants (88%) took outdoor walks, compared with less than half (46%) of the conventional care group (P<0.001) and were also more independent in outdoor activities (P = 0.0014). Conclusions: This study indicates that home rehabilitation, focused on supported discharge and enhancing self-efficacy, improves balance confidence, independence and physical activity in community-dwelling older adults in the early phase after hip fracture.

Personality Characteristics Determine Health-Related Quality of Life as an Outcome Indicator of Geriatric Inpatient Rehabilitation

Background. The aim of the present study was to investigate the relationships between personality and quality of life during the course of geriatric rehabilitation, against the background of Cloninger's biosocial theory of personality. Methods. All consecutive patients of a geriatric rehabilitation clinic during one year were evaluated at admission and discharge (N = 687) by means of the ‘‘Vienna List’’ (a newly developed questionnaire for the assessment of quality of life in patients with severe dementia), and two variants of the Temperament and Character Inventory. Results. Self-directedness showed the most general and highest impact on quality of life and successful rehabilitation. Conclusions. It is probable in old and very old individuals who are on their highest level of maturity that the character represents the most important regulatory system in the encounter with challenges of daily life, which necessitates rehabilitation.

Dietitians and physiotherapists necessary in rehabilitation of elderly

Dear Sir In a recent issue of the Journal, Poulsen et al. 1 studied the effects of individualized nursing care in elderly hospitalized patients. The setting was a geriatric rehabilitation clinic and the authors used a quasi-experimental design using one intervention unit and one control unit. The intervention consisted of intensified focus by nurses on nutrition. As it is stated in the article, “the authors did not have access to dietitians in this study”, neither is the term physiotherapy or physiotherapist mentioned. The main result in the study was that the two units did not differ in maintaining weight stability and functionality. However, the authors report that body weight increase was associated with functionality assessed by the Barthel index. Whether or not the results would had been different if dietitians and physiotherapists had been used as part of the intervention is impossible to say. But in future rehabilitation studies, it is our recommendation that a focus on teamwork, where different professions co-operate with a common goal, should be applied. In a recent study by Hojgaard Rasmussen et al. 2, a method for implementation of nutritional therapy in hospitals was presented and examined. They showed that one of the reasons for a successful implementation of nutritional therapy was a participating dietitian, with a clearly defined role, as part of the nutrition team in the unit. In patients with chronic obstructive pulmonary disease (COPD), it has been shown that a combination of nutritional support and exercise as an anabolic stimulus appears to be the best approach to obtain marked functional improvement 3. To ensure proper exercise, a physiotherapist should be involved. Further, in our opinion, functional improvement should preferably be assessed using standardized tests of muscle function, in addition to different form of indexes. In COPD patients 4, we have shown that body composition, expressed as fat-free mass index, is a better predictor of survival than body mass index (i.e. body weight and height). This is probably also the case for elderly hospitalized patients without COPD, and a measure of body composition as an outcome measure would show the effects of multidisciplinary interventions more clearly than measuring only body weight. In the future, we hope to see a multidisciplinary approach to rehabilitation and a more focused use of outcome measures. This would increase the evidence base for rehabilitation and also improve the between-disciplines understanding of each specialist's knowledge in the care of patients, and last but not least, give each patient a better chance of improving his or her muscle function and quality of life.

Attitudes of nursing staff working with older people towards nutritional nursing care

The aim of this study was to examine attitudes of the nursing staff in geriatric care towards factors of importance for nutritional nursing care. Studies show that nutritional risk assessment is seldom performed on older patients as routine and very few patients have a nutritional care plan. Patients in long-term care who are easy to feed are also found to be looked upon more positively than those with high feeding needs. A total of 252 registered nurses and nurse aids working at geriatric rehabilitation and medical care clinics and resident homes participated in the study. Attitudes were examined using the Staff Attitudes to Nutritional Nursing Care Geriatric scale. The scale includes 18 items and was designed as a one to five-point Lickert-type scale. It gives a total score and five subscales representing the dimensions 'Norms', 'Habits', 'Assessment', 'Intervention' and 'Individualization'. A higher score indicates a more positive attitude. Of all nursing staff, 53% displayed a positive attitude towards factors of importance for nutritional nursing care and the rest displayed a neutral or negative attitude. The 'Intervention' dimension, dealing with nutritional problems and how to manage them, reflected the highest level of positive attitudes, which represents 71% of the nursing staff. The 'Norms' dimension had the lowest relative frequency of positive attitudes, 27%. The registered nurses held significantly more positive attitudes than the nurse aids did. Nutritional issues comprise an important and time-consuming responsibility in geriatric care; however, nursing staff do not show an unequivocal positive attitude regarding this responsibility. The consequences this entails for the older patient need to be examined further. Relevance to clinical practice. Nursing staff play an important role in caring for patients who are malnourished or at risk for malnutrition. Positive attitudes might hinder the development of undernourishment or the further worsening of an already undernourished patient's condition.

Validation of the ?Vienna List? as a proxy measure of quality of life

The reason for the study was to investigate the discriminative, content- and criterion-related validity of the 'Vienna List', a newly developed proxy-rating measurement for quality of life in very old and severely demented persons. The total population of patients of a geriatric rehabilitation clinic of one year (from November 2001 to October 2002; n = 687) was evaluated at admission and discharge by means of this proxy rating method together with the mini mental state examination, the timed up and go test, the Tinetti measure, the Barthel Index, and the Katz activities of daily living list. Differences, mainly on factors communication, mobility, aggression, and negative affect, appeared between seven diagnostic groups as well between several care-related categories and destination after discharge. The five factors of the measurement explained a significant amount of variance with a high specificity and more than 50% of the Barthel Index scores. The 'Vienna List', originally developed for the assessment of quality of life in severely demented patients, proved to be a useful, differentiating, less time-consuming and practical tool for the documentation of the outcome of geriatric inpatient rehabilitation, as well.

Quality of life as an indicator for successful geriatric inpatient rehabilitation—a validation study of the ‘Vienna List’

Quality of life (QoL) appears as an adequate outcome measure of geriatric rehabilitation since it reflects its major goals in terms of improvement in self-service, mobility, interpersonal behavior and communication. The objective of the present study was the application of a newly developed instrument, the ‘Vienna List’, in this context. Its sensitivity to detect changes during geriatric rehabilitation and the ability to differentiate between various diseases and disturbances of functional abilities has been investigated. The total population of patients of one geriatric rehabilitation clinic of 1 year (from November 2001 to October 2002; N=683) was evaluated at admission and discharge by means of this proxy rating. Several reasonable differences appeared between seven diagnostic groups as well as between admission and discharge concerning crucial areas, which are the focus of geriatric rehabilitation such as communication and mobility and which reflect an improved QoL. On the other hand, some factors remained mostly unaffected, e.g. negative affect and bodily contact. The ‘Vienna List’ which was originally developed for the assessment of QoL in severely demented patients, proved to be a useful, differentiating, less time-consuming and practical tool for the documentation of the outcome of geriatric inpatient rehabilitation.

Estimating length of stay of geriatric rehabilitation patients

The aim of the study was to identify the most influential predictors of length of stay (LOS) among data, which are usually available on admission in geriatric rehabilitation units, such as diagnosis, functional limitations, age, gender, or marital status. Datasets of 6740 consecutive patients of a geriatric rehabilitation clinic have been retained for the analysis. As the density distribution of the LOS was grouped in intervals of 0-4, 4-6, 6-8 and 8 weeks and more, separate multivariate logistic regression models have been tested for the four intervals of LOS as well as for each of the four intervals separately. Some functional limitations on admission are significantly associated with longer LOS: limitations in dressing are associated with LOS of 6-8 weeks (OR = 1.47; CI = 1.32-1.65), and limitations in using the toilet are associated with LOS of 8 weeks and more (OR = 3.50; CI = 2.98-4.10). Shorter LOS of 0 to 4 weeks are significantly predicted by being respectively married (OR = 1.52; CI = 1.37-1.68), 75 years old and alder (OR = 1.29; CI = 1.16-1.43) or having a femur fracture (OR = 1.45; CI = 1.22-1.73). Single ADL-limitations such as in using the toilet or in dressing have a high predictivity of the LOS. Married patients and older patients are discharged earlier. Social characteristics like those subsumated under age or marital status seem to play a more important role as expected in determining the LOS in geriatric rehabilitation patients.