Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Prestroke Mobility and Dementia as Predictors of Stroke Outcomes in Patients Over 65 Years of Age: A Cohort Study From The Swedish Dementia and Stroke Registries
Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, Karolinska Institutet, Huddinge, Sweden.
Department of Geriatrics, Hospital Universitario de Getafe, Madrid, Spain.
Department of Neurology, University Medical Center, Ljubljana, Slovenia.
Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden.
Show others and affiliations
2018 (English)In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, p. 154-161Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objectives: To explore the association between prestroke mobility dependency and dementia on functioning and mortality outcomes after stroke in patients>65 years of age.

Design: Longitudinal cohort study based on SveDem, the Swedish Dementia Registry and Riksstroke, the Swedish Stroke Registry.

Participants: A total of 1689 patients with dementia >65 years of age registered in SveDem and suffering a first stroke between 2007 and 2014 were matched with 7973 controls without dementia with stroke.

Measurements: Odds ratios (ORs) and 95% confidence intervals (CIs) for intrahospital mortality, and functioning and mortality outcomes at 3 months were calculated. Functioning included level of residential assistance (living at home without help, at home with help, or nursing home) and mobility dependency (independent, needing help to move outdoors, or needing help indoors and outdoors).

Results: Prestroke dependency in activities of daily living and mobility were worse in patients with dementia than controls without dementia. In unadjusted analyses, patients with dementia were more often discharged to nursing homes (51% vs 20%; P < .001). Mortality at 3 months was higher in patients with dementia (31% vs 23% P < .001) and fewer were living at home without help (21% vs 55%; P < .001). In adjusted analyses, prestroke dementia was associated with higher risk of 3-month mortality (OR 1.34; 95% CI 1.18-1.52), requiring a higher level of residential assistance (OR 4.07; 3.49-.75) and suffering from more dependency in relation to mobility (OR 2.57; 2.20-3.02). Patients with dementia who were independent for mobility prestroke were more likely to be discharged to a nursing home compared with patients without dementia with the same prestroke mobility (37% vs 16%; P < .001), but there were no differences in discharge to geriatric rehabilitation (19% for both; P = .976). Patients, who moved independently before stroke, were more often discharged home (60% vs 28%) and had lower mortality. In adjusted analyses, prestroke mobility limitations were associated with higher odds for poorer mobility, needing more residential assistance, and death.

Conclusions: Patients with mobility impairments and/or dementia present a high burden of disability after a stroke. There is a need for research on stroke interventions among these populations.

Place, publisher, year, edition, pages
Elsevier, 2018. p. 154-161
Keyword [en]
Dementia, Frailty, Functioning, Mobility, Mortality, Stroke
National Category
Geriatrics
Identifiers
URN: urn:nbn:se:hj:diva-38350DOI: 10.1016/j.jamda.2017.08.014ISI: 000424413000013PubMedID: 28993049Scopus ID: 2-s2.0-85030791334Local ID: HHJARNISOAI: oai:DiVA.org:hj-38350DiVA: diva2:1170860
Available from: 2018-01-04 Created: 2018-01-04 Last updated: 2018-02-22Bibliographically approved

Open Access in DiVA

fulltext(559 kB)5 downloads
File information
File name FULLTEXT01.pdfFile size 559 kBChecksum SHA-512
cd2aaeeec695183b92b5b5ad1f7313532dcf54f4d545c6913d12f052170b5886bfd9d171a04e2d7be653fd4e25e5a814afd9b51be757fc486ae7d1504528770e
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMedScopus

Authority records BETA

Kåreholt, Ingemar

Search in DiVA

By author/editor
Kåreholt, Ingemar
By organisation
HHJ, Institute of GerontologyHHJ. ARN-J (Aging Research Network - Jönköping)
In the same journal
Journal of the American Medical Directors Association
Geriatrics

Search outside of DiVA

GoogleGoogle Scholar
Total: 5 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 15 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf