Clinical characteristics and functional outcome of stroke patients 75 years old and older

Kong, Keng-He; Chua, Karen Sui Geok; Tow, A

doi:10.1016/s0003-9993(98)90415-4

Cited by 55 publications

(33 citation statements)

References 15 publications

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“…Ebrahim et al (1985) identified cognitive problems in 12% of those surviving to six months. A later study by Kong et al (1998) detected cognitive impairment in 45% of their sample, although the difference may be ejqilained by the greater mean age in Kong's sanq)le. Cognitive impairment has been associated with both fimctional inpairment (Sisson, 1995;Tatemachi et al, 1994) and place of discharge .…”

Section: Cognitive Functionmentioning

confidence: 87%

“…Recent research has shoAvn that cognitive impairment may impact on the recovety process (Katz et al, 1999;Kong et al, 1998). For example, repeated practice of dressing, transfers and independent walking may fail or achieve only limited success if a patient has a disorder of short-term memory or object recognition.…”

Section: Patient Characteristics and Cognitive Impairmentmentioning

confidence: 99%

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Caregiver strain in spouses of stroke patients

Blake¹,

Lincoln²,

Clarke

2003

Clin Rehabil

107

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Objective: To test the ability of a previously generated logistic regression model to predict caregiver strain from carer mood, negative affectivity and perceived patient functional ability. Design: Postal prospective survey. Setting: Spouses of community-residing patients identified from hospital stroke registers. Method: Spouses were assessed at three and six months after stroke. A previously derived equation was used to make predictions at three months of their level of strain at six months, which were compared with observed outcomes. Measures: Spouses were asked to complete the Caregiver Strain Index (CSI), the General Health Questionnaire (GHQ-12), the Positive and Negative Affectivity Schedule (PANAS) and to assess patients' independence in activities of daily living on the Extended Activities of Daily Living Scale (EADL). Results: Of 409 stroke patients, 276 had an identifiable co-resident spouse and 116 (42%) completed the measures. At three months after stroke, 39 carers (34%) were under significant strain with 40 (35%) under strain at six months. The predictive model using the GHQ-12, PANAS and EADL at three months was 78% accurate in predicting levels of caregiver strain at six months. Conclusion: Carers at risk of later strain could be identified for further followup. Services to provide emotional support to carers might be effective in the reduction of carer strain.

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Section: Cognitive Functionmentioning

confidence: 87%

Section: Patient Characteristics and Cognitive Impairmentmentioning

confidence: 99%

Caregiver strain in spouses of stroke patients

Blake¹,

Lincoln²,

Clarke

2003

Clin Rehabil

107

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“…Old and young stroke survivors have different participation needs, influenced by age-related changes in social status, retirement and co-morbid factors [22]. In stroke survivors at vocational age, an important rehabilitation goal is returning to work.…”

Section: Introductionmentioning

confidence: 99%

Long-term restrictions in participation in stroke survivors under and over 70 years of age

Graaf

Mierlo

Post

et al. 2017

Disability and Rehabilitation

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Purpose: This study aims to (1) assess differences in participation restrictions between stroke survivors aged under and over 70 years and (2) identify predictors associated with favorable and unfavorable longterm participation in both age groups. Methods: Prospective cohort study in which 326 patients were assessed at stroke onset, two months and one year after stroke. The Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation) was used to measure participation restrictions one year after stroke. Bivariate and multivariate logistic regression analyses were performed including demographic factors, stroke-related factors, emotional functioning and comorbidity as possible predictors. Results: Stroke survivors aged over 70 years perceived more participation restrictions in comparison to stroke survivors aged under 70 years one year after stroke. Independently significant predictors for unfavorable participation outcomes were advancing age, more severe stroke and anxiety symptoms in patients aged over 70 years, and female gender, more severe stroke, impaired cognition and depression symptoms in patients aged under 70 years. Lower age was the only independent predictor associated with favorable participation after one year in stroke survivors aged over 70 years. Conclusions: This study emphasizes the need to pay more attention to participation restrictions in elderly stroke survivors. ä IMPLICATIONS FOR REHABILITATIONMore attention in the rehabilitation process should be paid to restrictions in participation of stroke survivors aged older than 70 years, taking into account the different participation needs and predictors of older stroke survivors. Early screening on the presence of anxiety symptoms could potentially prevent long-term restrictions in participation in stroke survivors aged over 70-year old. Stroke survivors experience considerable restrictions in physical activity and mobility after one year, highlighting the need for the development of community-based exercise programs for stroke survivors.ARTICLE HISTORY

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“…7 The risk for pneumonia is highest in the acute state of stroke, but it remains increased for up to several months during rehabilitation. 8 Reduction of bulbar reflexes, drowsiness, the bedridden patient's state, and subsequent aspiration are considered to account for the high incidence of bacterial pneumonia after stroke. However, aspiration alone cannot explain the high incidence of stroke-associated pneumonia.…”

mentioning

confidence: 99%

Stroke Propagates Bacterial Aspiration to Pneumonia in a Model of Cerebral Ischemia

Prass

Braun

Dirnagl

et al. 2006

Stroke

178

144

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Background and Purpose-Bacterial pneumonia is the most common cause of death in patients sustaining acute stroke and is believed to result from an increased aspiration. Recently, stroke-induced immunodeficiency was described in a mouse model of cerebral ischemia, which is primarily caused by overactivation of sympathetic nervous system. We tested if stroke-induced immunodeficiency increases the risk of pneumonia after aspiration in a newly developed model of poststroke pneumonia. Methods-Experimental stroke in mice was induced by occlusion of the middle cerebral artery (MCAO) for 60 minutes.Aspiration pneumonia was induced by intranasal application of 20 L of a defined suspension of Streptococcus pneumoniae in phosphate-buffered saline 4 or 14 days after MCAO. Treatment comprised moxifloxacin (100 mg/kg body weight, six times every 2 hours after operation) or propranolol (30 mg/kg body weight, immediately before as well as 4 and 8 hours after MCAO). Readout was lung histology and bacterial counts in lung and blood. Results-Nasal inoculation of only 200 colony-forming units of S pneumoniae caused severe pneumonia and bacteremia after experimental stroke, whereas 200 000 colony-forming units are needed to induce comparable disease in sham animals. Aspiration pneumonia in stroke animals outlasted acute stroke state but was preventable by ␤-adrenoreceptor blockade. Key Words: aspiration Ⅲ mice Ⅲ pneumonia Ⅲ Streptococcus pneumoniae Ⅲ stroke T he prognosis of stroke depends mainly on the incidence of complications. 1 Bacterial pneumonia is the most frequent severe complication 1-3 and the most common cause of death in patients sustaining a stroke. 4 Furthermore, its incidence correlates with the severity of stroke 5 and is associated with poor outcome. 6 However, even minor strokes, without clinical symptoms, may be complicated by pneumonia. 7 The risk for pneumonia is highest in the acute state of stroke, but it remains increased for up to several months during rehabilitation. 8 Reduction of bulbar reflexes, drowsiness, the bedridden patient's state, and subsequent aspiration are considered to account for the high incidence of bacterial pneumonia after stroke. However, aspiration alone cannot explain the high incidence of stroke-associated pneumonia. 9 Aspiration occurs in healthy adults during sleep without inducing pneumonia. 10 The reasons for the high incidence of pneumonia in patients sustaining a stroke are still incompletely understood. Conclusions-ExperimentalRecently, we described stroke-induced immunodeficiency in a mouse model of cerebral ischemia, 11 which is mainly caused by sympathetic nervous system overactivation and results in spontaneous bacterial infections resulting from impaired cell-mediated immune responses. In a newly developed model of poststroke pneumonia, we tested whether stroke-induced immunodeficiency increases the risk of pneumonia after aspiration. To induce pneumonia, we used Streptococcus pneumoniae as a result of its clinical relevance. Elderly and persons with coexisting diseases ...

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Clinical characteristics and functional outcome of stroke patients 75 years old and older

Cited by 55 publications

References 15 publications

Caregiver strain in spouses of stroke patients

Caregiver strain in spouses of stroke patients

Long-term restrictions in participation in stroke survivors under and over 70 years of age

Stroke Propagates Bacterial Aspiration to Pneumonia in a Model of Cerebral Ischemia

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