Psychological interventions with older adults during inpatient postacute rehabilitation: A systematic review.
Evan Plys, Cynthia D Morrow, Jennifer D Portz and 3 others
PMID 34472922WHAT IT FOUND
Psychological interventions for older adults in inpatient rehab lack high-quality evidence.
Anxiety showed no significant improvement. Depression results were mixed and unreliable due to high risk of bias. Clinicians cannot assume these therapies work in this setting.
Key findings
01The review found a lack of high-quality evidence for psychological interventions, with most studies having moderate to critical risk of bias.
02No included studies reported statistically significant between-group treatment benefits for anxiety.
03Depression outcomes were inconsistent, with some low-bias studies showing large effects but overall conclusions prohibited by methodological flaws.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Most studies had high, serious, or critical risk of bias. Sample sizes were small (range 6-113). Heterogeneity in intervention types (e.g., music, CBT, unstandardized) prevents pooling. Patients with moderate-severe cognitive impairment and aphasia were frequently excluded, limiting generalizability. No long-term follow-up after discharge was reported.
Declared interests
None reported.
The easy way to misread this
Do not interpret the large effect sizes for depression in some studies as proof of efficacy. These findings come from a small, highly heterogeneous, and biased evidence base that the authors explicitly state cannot support conclusions on effectiveness.