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. 2010 Jul 27;75(4):328-34.
doi: 10.1212/WNL.0b013e3181ea9f03. Epub 2010 Jun 23.

Quality of life declines after first ischemic stroke. The Northern Manhattan Study

M S Dhamoon  1 , Y P Moon, M C Paik, B Boden-Albala, T Rundek, R L Sacco, M S V Elkind
Affiliations

Quality of life declines after first ischemic stroke. The Northern Manhattan Study

M S Dhamoon et al. Neurology. .

Abstract

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 >/=40 years (mean age 68.6 +/- 12.4 years). QLI declined after stroke (annual change -0.10, 95% confidence interval -0.17 to -0.04), after adjusting for age, sex, race-ethnicity, education, insurance, depressed mood, stroke severity, bladder continence, and stroke laterality. This decline remained when BI >/=95 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 = 0.0017), with a decline for those with Medicaid/no insurance (p < 0.0001) but not Medicare/private insurance (p = 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.

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Figure Mean quality of life index (QLI) over 5 years of follow-up, stratified by insurance status
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References

    1. Lai SM, Studenski S, Duncan PW, Perera S. Persisting consequences of stroke measured by the Stroke Impact Scale. Stroke 2002;33:1840–1844. - PubMed
    1. Haacke C, Althaus A, Spottke A, Siebert U, Back T, Dodel R. Long-term outcome after stroke: evaluating health-related quality of life using utility measurements. Stroke 2006;37:193–198. - PubMed
    1. Duncan PW, Samsa GP, Weinberger M, et al. Health status of individuals with mild stroke. Stroke 1997;28:740–745. - PubMed
    1. Nys GM, van Zandvoort MJ, van der Worp HB, et al. Early cognitive impairment predicts long-term depressive symptoms and quality of life after stroke. J Neurol Sci 2006;247:149–156. - PubMed
    1. Paul SL, Sturm JW, Dewey HM, Donnan GA, Macdonell RA, Thrift AG. Long-term outcome in the North East Melbourne Stroke Incidence Study: predictors of quality of life at 5 years after stroke. Stroke 2005;36:2082–2086. - PubMed

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