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Abstract
Background: Studying long-term stroke outcomes including body functioning (neurologic and neuropsychological impairments) and activity limitations and participation is essential for long-term evidence-based rehabilitation and service planning, resource allocation, and improving health outcomes in stroke. However, reliable data to address these issues is lacking.
Methods: This study (February 2007–December 2008) sourced its participants from the population-based incidence study conducted in Auckland in 2002–2003. Participants completed structured self-administered questionnaires, and a face-to-face interview including a battery of neuropsychological tests. Logistic regression analysis was used to analyze associations between and within functional outcomes and their potential predictors.
Results: Of 418 5-year stroke survivors, two-thirds had good functional outcome in terms of neurologic impairment and disability (defined as modified Rankin Score <3), 22.5% had cognitive impairment indicative of dementia, 20% had experienced a recurrent stroke, almost 15% were institutionalized, and 29.6% had symptoms suggesting depression. Highly significant correlations were found between and within various measurements of body functioning (especially neuropsychological impairments), activity, and participation. Age, dependency, and depression were independently associated with most outcomes analyzed.
Conclusions: The strong associations between neuropsychological impairment and other functional outcomes and across various measurements of body functioning, activity, and participation justify utilizing a multidisciplinary approach to studying and managing long-term stroke outcomes. Observed gender and ethnic differences in some important stroke outcomes warrant further investigations.
Footnotes
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Study funding: Supported by the Health Research Council of New Zealand.
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- ADL
- activities of daily living
- ARCOS
- Auckland Regional Community Stroke study
- ASTRO
- Auckland Stroke Outcomes study
- BD
- Block Design
- BI
- Barthel Index
- BNT
- Boston Naming Test
- COWA
- Controlled Oral Word Association
- CVLT-II
- California Verbal Learning Test, 2nd edition
- FAI
- Frenchay Activity Index
- GDS-15
- 15-item Geriatric Depression Scale
- GHQ-28
- General Health Questionnaire–28
- HMT
- Hodkinson Abbreviated Mental Test
- ICH
- intracerebral hemorrhage
- IPS
- information processing speed
- IS
- ischemic stroke
- IVA-CPT
- Integrated Visual Auditory-Continuous Performance Test
- LHS
- London Handicap Scale
- LM
- Logical Memory
- MCS
- Mental Component Score
- MR
- Matrix Reasoning
- mRS
- modified Rankin Scale
- NIHSS
- NIH Stroke Scale
- PCRS
- Patient Competency Rating Scale
- PCS
- Physical Component Score
- ROCF
- Rey-Osterrieth Complex Figure
- SAH
- subarachnoid hemorrhage
- SF-36
- Short Form–36
- UND
- undetermined
- VPA
- Visual Paired Associates
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See page 1608.
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Supplemental data at www.neurology.org.
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References e1–e15 are available on the Neurology® Web site at www.neurology.org.
- Received May 4, 2010.
- Accepted July 20, 2010.
- Copyright © 2010 by AAN Enterprises, Inc.
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