Quality of Life and its Determinants after Stroke in Elderly Patients

Abstract

Background Stroke is one of the most common morbidities in elderly all over the world, with studies showing prevalence more than 50% in elderly individuals > 60 years (1), by 2050, the global number of old people (aged ≥65 years) will be greater than the number of young people (aged <65 years) for the first time since formal records began (2). This growth in the aged population, together with the influence of aging on stroke, suggests that the incidence and economic cost of this disease will increase (3). Stroke is the main cause of serious, long-term neurologic impairment and functional disability. Depending on the severity, a stroke can leave an individual with residual impairment of physical, psychological, social and cognitive function (4). An older person needs more assistance in daily living or requires placement in an institution than a younger patient with stroke (5). The dramatic clinical effect of stroke on older patients can be due to changes in the vascular response to stress and injury with increasing age, which can be due to factors such as pre stroke medical and functional status, multiple organ dysfunctions, polypharmacy, and stroke severity (6). Meanwhile Health was defined in the World Health Organization (WHO) Constitution as "a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity" (7). Measuring health related quality of life (HRQOL) in elderly enable them to maintain their mobility, independence, their active contribution to society, and to respond effectively to the challenges of older age and bring an active aging for them (8). Elderly with multiple disorders often experience problems that adversely influence their HRQoL (9). Therefore, investigating HRQoL of the elderly is especially important because health issues limit their independence and ability to engage in life activities. Despite the growing interest in quality of life (QoL) issues in clinical research and practice, little attention has been paid to evaluating systematically the QoL of stroke patients. QoL investigations are useful in gaining a better understanding of patients' reactions to illness and for enhancing supportive care and also for evaluating the efficacy of therapeutic interventions. Although there is an association between neurological deficits and QL, they are not synonymous (10). So the aim of this study is to assess the impact of stroke on quality of life of elderly and to identify the determinant of QoL in geriatric stroke patients.