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Physical function, disability and rehabilitation in the elderly critically ill

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Personnes âgées et réanimation

Part of the book series: Références en réanimation. Collection de la SRLF ((SRLF))

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Abstract

Older patients with critical illness comprise almost one-half of ICU admissions and represent a vulnerable patient subgroup in terms of incremental functional and neuropsychological disability sustained as a result of their critical illness [1]. We know that most patients who survive an episode of critical illness will have compromised physical function secondary to Intensive Care Unit-Acquired Weakness (ICUAW) and other physical disabilities [2–6]. Disability may be permanent [6], and the constellation of muscle, nerve and brain dysfunction [4, 7–12] may permanently alter disposition for those who were previously independent, may impose an additional healthcare cost burden [2, 6, 13, 14], and erode the reserve of family members [15–18]. Older patients may come to their episode of critical illness with less organ reserve than their younger counterparts, and the superimposed physical dysfunction associated with their illness may result in new disability. However, this literature suffers from selection bias in terms of who among the elderly is admitted to an ICU, the survivorship bias associated with high ICU and post-discharge mortality, and the challenges of long-term follow-up in this population. There remains a lingering uncertainty about the benefit of critical care in this vulnerable group.

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  1. Critical Care Medicine, University of Toronto, Toronto General Hospital, 11C-1180 585 University Avenue, Toronto, Ontario, M5G 2C4, Canada

    M. E. Detsky

  2. Critical Care and Respiratory Medicine, University of Toronto, Toronto General Hospital, 11C-1180 585 University Avenue, Toronto, Ontario, M5G 2C4, Canada

    M. S. Herridge

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Detsky, M.E., Herridge, M.S. (2012). Physical function, disability and rehabilitation in the elderly critically ill. In: Personnes âgées et réanimation. Références en réanimation. Collection de la SRLF. Springer, Paris. https://doi.org/10.1007/978-2-8178-0287-9_12

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