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. 2023 Dec;14(6):1343-1351.
doi: 10.1007/s41999-023-00885-9. Epub 2023 Nov 7.

Functioning and recovery during stroke rehabilitation: a comparison between pre-stroke frail and non-frail patients

Åsa Mennema  1   2 , Thea P M Vliet Vlieland  3   4 , Wilco P Achterberg  5 , Daniëlla M Oosterveer  3   4   6 ; SCORE-study group
Affiliations

Functioning and recovery during stroke rehabilitation: a comparison between pre-stroke frail and non-frail patients

Åsa Mennema et al. Eur Geriatr Med. 2023 Dec.

Abstract

Purpose: Pre-stroke frailty in older adults is associated with adverse outcomes after stroke in community-based and hospital-based populations. The aim of our study was to investigate the prevalence of pre-stroke frailty among older stroke survivors receiving medical specialistic rehabilitation and its association with outcomes and recovery.

Methods: Pre-stroke frailty was measured by the Groningen Frailty Indicator (GFI, score ≥ 4 indicates frailty) in patients ≥ 65 years receiving stroke medical specialistic rehabilitation. Baseline, follow-up and change (i.e. recovery) scores of the Barthel index (BI), Stroke Impact Scale (SIS) 'mobility', 'communication', and 'memory and thinking', Hospital Anxiety and Depression Scale (HADS) and the EuroQoL-5 dimensions (EQ-5D) were compared between frail and non-frail patients with a multivariable regression model adjusting for confounders.

Results: Of 322 included patients (34.2% females, median age 70 years), 43 (13.4%) patients reported pre-stroke frailty. There were no differences in BI or in destination of discharge between pre-stroke frail and non-frail stroke survivors receiving inpatient rehabilitation. However, pre-stroke frailty was associated with worse follow-up scores for all other measures. Recovery in pre-stroke frail patients was less favorable compared to non-frail patients for SIS mobility, HADS subscales and EQ-5D index and visual analogue scale.

Conclusion: Pre-stroke frailty was present in a minority of older stroke survivors receiving medical specialistic rehabilitation. BI and destination of discharge did not differ. Nevertheless, pre-stroke frailty was associated with worse functioning at follow-up for most measures of health status and with smaller improvements in mobility, mood and quality of life.

Keywords: Frailty; Outcomes; Rehabilitation; Stroke.

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Conflict of interest statement

The authors have no conflict of interest to declare.

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