Associations between diagnosis with stroke, comorbidities, and activity of daily living among older adults in the United States

Abstract

Background: Stroke is the leading cause of mortality. This study aimed to investigate the association between stroke, comorbidities, and activity of daily living (ADL) among older adults in the United States.

Methods: Participants were 1165 older adults aged 60 and older from two waves (2016 and 2018) of the Health and Retirement Study who had a stroke. Descriptive statistics were used to describe demographic information and comorbidities. Logistic regressions and multiple regression analyses were used to determine associations between stroke, comorbidities, and ADL.

Results: The mean age was 75.32 ± 9.5 years, and 55.6% were female. An adjusted analysis shows that older stroke adults living with diabetes as comorbidity are significantly associated with difficulty in dressing, walking, bedding, and toileting. Moreover, depression was significantly associated with difficulty in dressing, walking, bathing, eating, and bedding. At the same time, heart conditions and hypertension as comorbidity were rarely associated with difficulty in ADL. After adjusting for age and sex, heart condition and depression are significantly associated with seeing a doctor for stroke (odds ratio [OR]: 0.66; 95% confidence interval [CI]: 0.49-0.91; p = 0.01) and stroke therapy (OR: 0.46; 95% CI: 0.25-0.84; p = 0.01). Finally, stroke problem (unstandardized β [B] = 0.58, p = 0.017) and stroke therapy (B = 1.42, p < 0.001) significantly predict a lower level of independence.

Conclusion: This study could benefit healthcare professionals in developing further interventions to improve older stroke adults' lives, especially those with a high level of dependence.

Keywords: activity of daily living; comorbidity; older adults; stroke.