Long-Term Functional Recovery After First Ischemic Stroke

Dhamoon, Mandip S.; Moon, Yumin; Paik, Myunghee Cho; Boden‐Albala, Bernadette; Rundek, Tatjana; Sacco, Ralph L.; Elkind, Mitchell S.V.

doi:10.1161/strokeaha.109.549576

Cited by 212 publications

(187 citation statements)

References 47 publications

Supporting

Mentioning

171

Contrasting

Unclassified

Order By: Relevance

“…Similar to our study, age, 1,4 mood or depression, 2 stroke severity, 5,6 urinary incontinence, 37 side of stroke, 38 and DM 1 were also predictors of QOL in previous studies. Decline in QOL was most prominent in the domains of activity, daily living, and support, which is consistent with prior findings in this population, 8 and suggests that decline in QOL may be associated with decline in functional and occupational status. The interaction between time and insurance status in the domain of outlook suggests that limited access to care may have an impact on one's sense of control in matters of health.…”

Section: Discussionsupporting

confidence: 89%

“…Our prior research provided evidence that disability increased over time after stroke independently of recurrence. 8 We hypothesized that ischemic stroke patients would similarly experience decline in QOL over 5 years independent of recurrent stroke and other risk factors. Since validated stroke-specific QOL scales were not available at the time of the design of this study, we used a validated generic QOL scale, the Spitzer QLI, 9 which has been used extensively in prior research in various diseases.…”

mentioning

confidence: 99%

“…In a separate model, we additionally adjusted for functional status as a time-dependent covariate, using categories of functional independence (BI Ն95) and dependence (BI Ͻ95), as in our prior analysis. 8 Insurance status was characterized as Medicare/private insurance vs Medicaid/no insurance.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Quality of life declines after first ischemic stroke

Dhamoon

Moon²,

Paik³

et al. 2010

Neurology

View full text Add to dashboard Cite

Objectives: Quality of life (QOL) after stroke is poorly characterized. We sought to determine long-term natural history and predictors of QOL among first ischemic stroke survivors without stroke recurrence or myocardial infarction (MI). Methods:In the population-based, multiethnic Northern Manhattan Study, QOL was prospectively assessed at 6 months and annually for 5 years using the Spitzer QOL index (QLI), a 10-point scale. Functional status was assessed using the Barthel Index (BI) at regular intervals, and cognition using the Mini-Mental State Examination at 1 year. Generalized estimating equations estimated the association between patient characteristics and repeated QOL measures over 5 years. Follow-up was censored at death, recurrent stroke, or MI.Results: There were 525 incident ischemic stroke patients Ն40 years (mean age 68.6 Ϯ 12.4 years). QLI declined after stroke (annual change Ϫ0.10, 95% confidence interval Ϫ0.17 to Ϫ0.04), after adjusting for age, sex, race-ethnicity, education, insurance, depressed mood, stroke severity, bladder continence, and stroke laterality. This decline remained when BI Ն95 was added to the model as a time-dependent covariate, and functional status also predicted QLI. Changes in QLI over time differed by insurance status (p for interaction ϭ 0.0017), with a decline for those with Medicaid/no insurance (p Ͻ 0.0001) but not Medicare/private insurance (p ϭ 0.98). Conclusions:In this population-based study, QOL declined annually up to 5 years after stroke among survivors free of recurrence or MI and independently of other risk factors. QLI declined more among Medicaid patients and was associated with age, mood, stroke severity, urinary incontinence, functional status, cognition, and stroke laterality. Neurology ® 2010;75:328 -334 GLOSSARY BI ϭ Barthel Index; CAD ϭ coronary artery disease; CHF ϭ congestive heart failure; CI ϭ confidence interval; CUMC ϭ Columbia University Medical Center; DM ϭ diabetes mellitus; GEE ϭ generalized estimating equation; HTN ϭ hypertension; MI ϭ myocardial infarction; MMSE ϭ Mini-Mental State Examination; NIHSS ϭ NIH Stroke Scale; NOMAS ϭ Northern Manhattan Study; QOL ϭ quality of life; QLI ϭ quality of life index.Stroke causes a significant decrease in quality of life (QOL), even among those who have no poststroke disability.1 Prior studies examining QOL in stroke survivors have been limited by hospitalized samples, 2 cross-sectional design, 3 small sample sizes, 2 and samples with both hemorrhagic and ischemic strokes. 1,2,4,5 Longitudinal studies have been limited by short follow-up and enrollment of patients in different stages of early poststroke recovery. Few long-term population-based studies have systematically examined QOL after stroke. Those studies have been limited by few follow-up assessments 5,6 and significant loss to follow-up. 5 No study, to our knowledge, has censored recurrent vascular events, and the natural history and determinants of long-term QOL after a single ischemic stroke are not known. Finally, the effect of acce...

show abstract

Section: Discussionsupporting

confidence: 89%

mentioning

confidence: 99%

See 1 more Smart Citation

Quality of life declines after first ischemic stroke

Dhamoon

Moon²,

Paik³

et al. 2010

Neurology

View full text Add to dashboard Cite

show abstract

“…Various studies have concluded that it is predictive of stroke outcomes. [16][17][18] One study demonstrated that severity of stroke assessed by NIHSS at admission to be predictive of 3 month mortality and another study established it as an independent predictor of 30 days mortality.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of C-Reactive Protein in Acute Stroke

James¹,

Mangalasundaram²,

Radhakrishnan³

2016

jemds

View full text Add to dashboard Cite

show abstract

“…Outro fator pessoal que pode ser considerado é o tempo de evolução após o AVE 8 . Ainda não foi reportado na literatura a existência de associação dessa variável com restrição na participação social, no entanto, estudo prévio demonstrou declínio funcional em indivíduos pós-AVE com o passar dos anos, sendo esse declínio independente de fatores como idade, gravidade e recorrência do AVE 9 . A caracterização da participação social após o AVE pode demonstrar o grau de envolvimento dos indivíduos nas situações de vida cotidiana.…”

unclassified

Caracterização da participação social de indivíduos na fase crônica pós-acidente vascular encefálico

Faria‐Fortini¹,

Basílio²,

Polese³

et al. 2017

Rev. Ter. Ocup. Univ. São Paulo (Online)

View full text Add to dashboard Cite

O objetivo foi descrever e comparar diferenças na restrição na participação social de indivíduos após acidente vascular encefálico (AVE) na fase crônica, considerando as deficiências, limitações em mobilidade e fatores pessoais. A restrição na participação social foi mensurada pelo LIFE-H 3.1-Brasil; as deficiências pela Escala de Depressão Geriátrica e Escala de Fugl-Meyer (EFM); as limitações em mobilidade pela velocidade de marcha e Timed Up & Go (TUG) e os fatores pessoais incluíram sexo, idade, situação familiar e tempo de evolução pós-AVE. Observou-se restrição significativa na área de recreação. Em geral, restrições na participação social foram observadas em participantes com escores ≤28 na EFM-membro inferior, sintomas de depressão, marcha comunitária limitada, risco de quedas e tempo de evolução ≤5 anos. Aqueles com escores ≤45 na EFM-membro superior apresentaram maior restrição em algumas áreas das atividades diárias. As mulheres apresentaram maior restrição em papéis sociais. Os resultados sugerem que deficiências e limitações relacionadas aos membros inferiores, sintomas depressivos e tempo de evolução devem ser considerados na avaliação, quando o objetivo da reabilitação for aumentar a participação social de indivíduos pós-AVE.

show abstract

Long-Term Functional Recovery After First Ischemic Stroke

Cited by 212 publications

References 47 publications

Quality of life declines after first ischemic stroke

Quality of life declines after first ischemic stroke

Prognostic Significance of C-Reactive Protein in Acute Stroke

Caracterização da participação social de indivíduos na fase crônica pós-acidente vascular encefálico

Contact Info

Product

Resources

About