disability Lacunar stroke quality of life recovery
We sought to describe the course and predictors of quality of life (QOL) after lacunar stroke. We hypothesized that there is a decline in QOL after recovery from lacunar stroke.
The Secondary Prevention of Small Subcortical Strokes is a clinical trial in lacunar stroke patients with annual assessments of QOL with the stroke-specific QOL score. The overall score was used and analyzed as a continuous variable (range 0-5). We fit linear mixed models to assess the trend in QOL over time, assuming linearity of time, and adjusted for demographics, medical risk factors, cognitive factors, and functional status in univariable and multivariable models.
Among 2870 participants, mean age was 63.4 years (SD 10.7), 63% were men, 51% White, 32% Hispanic, 36% had college education, 36% had diabetes, 89% had hypertension, and 10% had prior stroke. Mean poststroke Barthel Index (BI) score was 95.4 (assessed on average 6 months after stroke). In the final multivariable model, there was an average increase in QOL of .6% per year, and factors associated with decline in QOL over time included age (−.0003 per year, P < .0001), any college education (−.0013 per year, .01), prior stroke (−.004 per year, P < .0001), and BI (−.0002 per year, P < .0001).
In this clinical trial of lacunar stroke patients, there was a slight annual increase in QOL overall, and age, level of education, and prior stroke were associated with changes in QOL over time. Multiple strokes may cause decline in QOL over time in the absence of recurrent events.
Quality of Life after Lacunar Stroke: The Secondary Prevention of Small Subcortical Strokes Study
Creators
Mandip S. Dhamoon - Icahn School of Medicine at Mount Sinai
Leslie A. McClure - University of Alabama at Birmingham
Carole L. White - School of Nursing, University of Texas Health Sciences Center, San Antonio, Texas
Helena Lau - Boston University
Oscar Benavente - University of British Columbia
Mitchell S.V. Elkind - Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
Publication Details
Journal of stroke and cerebrovascular diseases, v 23(5), pp 1131-1137
Publisher
Elsevier
Grant note
Bristol-Myers Squibb/Sanofi Pharmaceuticals
R01 NS050724; NS048134; P50 NS049060; R27 NS029993; R01 NS55809; R01 NS062820 / National Institutes of Health/National Institute of Neurological Disorders and Stroke
diaDexus, Inc.
U01 NS38529-04A1 / National Institute of Neurological Disorders and Stroke
Resource Type
Journal article
Language
English
Academic Unit
Epidemiology and Biostatistics
Web of Science ID
WOS:000336482000063
Scopus ID
2-s2.0-84901307347
Other Identifier
991019231634504721
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