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Factors Associated With Ischemic Stroke Survival and Recovery in Older Adults.
Winovich, Divya Thekkethala; Longstreth, William T; Arnold, Alice M; Varadhan, Ravi; Zeki Al Hazzouri, Adina; Cushman, Mary; Newman, Anne B; Odden, Michelle C.
Afiliação
  • Winovich DT; From the School of Biological and Population Health Sciences, Oregon State University, Corvallis (D.T.W., M.C.O.); School of Medicine, Oregon Health and Science University, Portland (D.T.W.); Department of Neurology (W.T.L.), and Department of Biostatistics (A.M.A.), University of Washington, Seattl
  • Longstreth WT; From the School of Biological and Population Health Sciences, Oregon State University, Corvallis (D.T.W., M.C.O.); School of Medicine, Oregon Health and Science University, Portland (D.T.W.); Department of Neurology (W.T.L.), and Department of Biostatistics (A.M.A.), University of Washington, Seattl
  • Arnold AM; From the School of Biological and Population Health Sciences, Oregon State University, Corvallis (D.T.W., M.C.O.); School of Medicine, Oregon Health and Science University, Portland (D.T.W.); Department of Neurology (W.T.L.), and Department of Biostatistics (A.M.A.), University of Washington, Seattl
  • Varadhan R; From the School of Biological and Population Health Sciences, Oregon State University, Corvallis (D.T.W., M.C.O.); School of Medicine, Oregon Health and Science University, Portland (D.T.W.); Department of Neurology (W.T.L.), and Department of Biostatistics (A.M.A.), University of Washington, Seattl
  • Zeki Al Hazzouri A; From the School of Biological and Population Health Sciences, Oregon State University, Corvallis (D.T.W., M.C.O.); School of Medicine, Oregon Health and Science University, Portland (D.T.W.); Department of Neurology (W.T.L.), and Department of Biostatistics (A.M.A.), University of Washington, Seattl
  • Cushman M; From the School of Biological and Population Health Sciences, Oregon State University, Corvallis (D.T.W., M.C.O.); School of Medicine, Oregon Health and Science University, Portland (D.T.W.); Department of Neurology (W.T.L.), and Department of Biostatistics (A.M.A.), University of Washington, Seattl
  • Newman AB; From the School of Biological and Population Health Sciences, Oregon State University, Corvallis (D.T.W., M.C.O.); School of Medicine, Oregon Health and Science University, Portland (D.T.W.); Department of Neurology (W.T.L.), and Department of Biostatistics (A.M.A.), University of Washington, Seattl
  • Odden MC; From the School of Biological and Population Health Sciences, Oregon State University, Corvallis (D.T.W., M.C.O.); School of Medicine, Oregon Health and Science University, Portland (D.T.W.); Department of Neurology (W.T.L.), and Department of Biostatistics (A.M.A.), University of Washington, Seattl
Stroke ; 48(7): 1818-1826, 2017 07.
Article em En | MEDLINE | ID: mdl-28526765
BACKGROUND AND PURPOSE: Little is known about factors that predispose older adults to poor recovery after a stroke. In this study, we sought to evaluate prestroke measures of frailty and related factors as markers of vulnerability to poor outcomes after ischemic stroke. METHODS: In participants aged 65 to 99 years with incident ischemic strokes from the Cardiovascular Health Study, we evaluated the association of several risk factors (frailty, frailty components, C-reactive protein, interleukin-6, and cystatin C) assessed before stroke with stroke outcomes of survival, cognitive decline (≥5 points on Modified Mini-Mental State Examination), and activities of daily living decline (increase in limitations). RESULTS: Among 717 participants with incident ischemic stroke with survival data, slow walking speed, low grip strength, and cystatin C were independently associated with shorter survival. Among participants <80 years of age, frailty and interleukin-6 were also associated with shorter survival. Among 509 participants with recovery data, slow walking speed, and low grip strength were associated with both cognitive and activities of daily living decline poststroke. C-reactive protein and interleukin-6 were associated with poststroke cognitive decline among men only. Frailty status was associated with activities of daily living decline among women only. CONCLUSIONS: Markers of physical function-walking speed and grip strength-were consistently associated with survival and recovery after ischemic stroke. Inflammation, kidney function, and frailty also seemed to be determinants of survival and recovery after an ischemic stroke. These markers of vulnerability may identify targets for differing pre and poststroke medical management and rehabilitation among older adults at risk of poor stroke outcomes.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Isquemia Encefálica / Idoso Fragilizado / Recuperação de Função Fisiológica / Acidente Vascular Cerebral Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Stroke Ano de publicação: 2017 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Isquemia Encefálica / Idoso Fragilizado / Recuperação de Função Fisiológica / Acidente Vascular Cerebral Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Stroke Ano de publicação: 2017 Tipo de documento: Article País de publicação: Estados Unidos