Functioning and Recovery During Stroke Rehabilitation: a Comparison Between Pre-stroke Frail and Non-frail Patients

Overview

Journal Eur Geriatr Med

Specialty Geriatrics

Date 2023 Nov 7

PMID 37935943

Authors

Asa Mennema

Thea P M Vliet Vlieland

Wilco P Achterberg

Daniella M Oosterveer

Affiliations

Soon will be listed here.

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.

Citing Articles

Association between pre-stroke frailty status and stroke risk and impact on outcomes: a systematic review and meta-analysis of 1,660,328 participants.

Chen S, Li H, Guo Z, Ling K, Yu X, Liu F Aging Clin Exp Res. 2024; 36(1):189.

PMID: 39259235 PMC: 11390839. DOI: 10.1007/s40520-024-02845-0.

Impact of Frailty on Healthcare Outcomes after Cardioembolic Ischaemic Stroke Due to Atrial Fibrillation.

OCaoimh R, Morrison L, Hanley M, McManus C, Donlon K, Galvin P Int J Environ Res Public Health. 2024; 21(3).

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