Prevalence and Risk Factors of Frailty in Stroke Patients: A Meta-Analysis and Systematic Review

Huang, Yiwei; Yan, F.; Wang, X. Y.; Chen, X. L.; Chong, H. Y.; Su, Wenting; Chen, Y. R.; Han, Lin; Ma, Yuxia X.

doi:10.1007/s12603-023-1879-z

Cited by 11 publications

(5 citation statements)

References 59 publications

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“…32 However, no matter in urban or rural areas, PAE compliance is not very good, which may be related to the cognitive and physical frailty caused by stroke, and studies have indeed confirmed that frailty affects the compliance behavior of individuals with stroke. 41,42 Regarding the influential factors of PAE adherence in this study, knowledge about physical activity was a positive factor, as well as attitudes toward stroke. However, the results showed that after discharge, stroke patients in rural areas had very limited knowledge about stroke, the total accuracy rate of the knowledge section was less than 50% (48.69%).…”

Section: Discussionmentioning

confidence: 64%

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An Age-Stratified Cross-Sectional Study of Physical Activity and Exercise Adherence of Stroke Survivors in Rural Regions

Lin¹,

Xue²,

Zhang³

et al. 2023

PPA

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Objective To describe the Physical Activity and Exercise (PAE) adherence of stroke survivors in rural regions, additionally, to analyze the influential factors through age stratification. Methods This is a cross-sectional study. Totally, 596 stroke patients (65.70±10.76 years) from three rural regions were selected, PAE scale was used for measuring compliance. The influential factors among different age groups were explored separately. This study adheres to the EQUATOR checklist, SROBE. Results Only 17.8% (106) of participants regularly participated in PAE. Altogether, 42.45% were classified as a young-middle age group, and the rest 57.55% were in the old age group. Positive attitudes and better PAE-relevant knowledge were protective factors for adherence in the young and middle-aged group (OR=0.683; 95% CI 0.173~0.588 and OR=0.939; 95% CI 0.013~0.114), as well as in the old group (OR=0.704; 95% CI 0.193~0.534 and OR=0.929; 95% CI 0.035~0.118); having no home rehabilitation equipment was a strong risk factor for younger patients (OR=16.078; 95% CI 1.235~4.320); however, without hemiplegia can positively affect their adherence (OR=0.891; 95% CI 0.045~0.229). In addition, the presence of a spouse can lead to a better compliance among old patients (OR=0.436; 95% CI −0.496~-0.165). Conclusion It is necessary to improve the knowledge of physical activity in rural stroke patients of all ages. It is of great significance to install home rehabilitation equipment to promote exercise for young and middle-aged stroke patients. While for the old stroke patients, we strongly suggest focusing on the role of spouses, which would be more useful in low-income regions.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

An Age-Stratified Cross-Sectional Study of Physical Activity and Exercise Adherence of Stroke Survivors in Rural Regions

Lin¹,

Xue²,

Zhang³

et al. 2023

PPA

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“…2 In this older cohort, we also found no difference in frailty prevalence by stroke type. A metanalysis of 24 studies reported that frailty was more prevalent in IS than ICH, 38 but this result may derive from the inclusion of studies involving patients aged less that 65 years, with data for ICH mostly coming from younger cohorts.…”

Section: Discussionmentioning

confidence: 99%

“…The copyright holder for this this version posted December 7, 2023. ; https://doi.org/10.1101/2023.12.05.23299569 doi: medRxiv preprint Previous studies of frailty occurrence in older stroke patients produced inconsistent results, mainly because of the great heterogeneity in the operational definition of frailty (estimates ranging from 2% to 68%). 3,38 Most of these studies are not comparable with ours because they used variations of the physical frailty phenotype, which is based on motor and activity measures, or frailty cumulative indexes, which variably incorporate measures of function, cognition, comorbidities, and social factors. 2 Two studies of IS patients using CFS reported frailty prevalence estimates ranging between 38% 20 and 54%, 18 which agree with our findings.…”

Section: Discussionmentioning

confidence: 99%

Association between frailty assessed by the Clinical Frailty Scale 2.0 and outcomes of acute stroke in older patients

Forti,

Ciani,

Maioli

2023

Preprint

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BackgroundFrailty is a geriatric syndrome characterized by an increased vulnerability to stressors and increased risk of adverse clinical outcomes. While older patients with acute stroke are routinely screened for prestroke disability using the modified Rankin Scale (mRS), because of its known association with stroke outcomes, prestroke frailty is still rarely assessed. The Clinical Frailty Scale (CFS) is a popoular tool for retrospective frailty assessment in the acute setting. The study hypothesis was that prestroke frailty measured with CFS was associated with stroke outcome of older patients independent of prestroke disability assessed with mRS.MethodsWe recruited 4086 individuals aged ≥65 years consecutively admitted with acute stroke to an Italian hospital. Prestroke disability (mRS ≥3) was assessed at admission. Prestroke CFS was retrospectively assessed using information from the medical records. Logistic models determined the association of CFS with poor functional outcome, prolonged discharge, unfavorable discharge setting, and poor rehabilitation potential. Cox models determined the association of CFS with 30-day and 1-month mortality. All models were adjusted for prestroke disability and other major confounders.ResultsParticipants were median age 81 years (25th-75th percentile, 75-87 years), 55.0% female, 82.6% with ischemic stroke, and 26.3% with prestroke disability. Overall prevalence of prestroke frailty (CFS ≥4) was 41.6%. Multivariable-adjusted logistic models showed that CFS was associated with increasing risk of all outcomes except prologed discharge. In severe frailty (CFS 7-8), OR (95%CI) was 3.44 (2.33-5.07) for poor functional outcome, 0.53 (0.38-0.75) for prolonged discharge, 1.89 (0.36-263) for unfavourable discharge, and 6.24 (3.80-10.26) for poor rehabilitation potential (reference CFS 1-3). In multivariable adjusted-Cox models, CFS was unrelated to 30-day mortality but HR (95%CI) of 1-year mortality was significant for both CFS 4-6 (1.70, 1.36-2.11) and CFS 7-8 (1.69, 1.25-2.30).ConclusionsPrestroke frailty measured with CFS was associated with higher risk of several adverse outcomes even after adjustment for prestroke disability and other major confounders.

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“…Los factores de riesgo no modificables son aquellos en los que no se puede influir de forma directa. Se ha observado que el ictus está asociado a la edad, siendo los de edades más avanzadas los que tienen un mayor riesgo, sobre todo entre el sexo masculino [59][60][61]. En relación a la raza, son los asiáticos y la raza negra los que han demostrado un mayor riesgo de ictus [62,63].…”

Section: Factores De Riesgounclassified

Efectos de la Terapia en Espejo vs. Ejercicio Terapéutico Cognoscitivo en la mejora de las funciones del miembro superior en pacientes con ictus

Fernández Solana

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Prevalence and Risk Factors of Frailty in Stroke Patients: A Meta-Analysis and Systematic Review

Cited by 11 publications

References 59 publications

An Age-Stratified Cross-Sectional Study of Physical Activity and Exercise Adherence of Stroke Survivors in Rural Regions

An Age-Stratified Cross-Sectional Study of Physical Activity and Exercise Adherence of Stroke Survivors in Rural Regions

Association between frailty assessed by the Clinical Frailty Scale 2.0 and outcomes of acute stroke in older patients

Efectos de la Terapia en Espejo vs. Ejercicio Terapéutico Cognoscitivo en la mejora de las funciones del miembro superior en pacientes con ictus

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