title: Stroke in an elderly population: incidence and impact on survival and daily function. The Italian Longitudinal Study on Aging.
abstract: BACKGROUND
  Epidemiological data are essential to estimate the burden of stroke. We evaluated stroke incidence in older Italians and the effect of first-ever stroke on survival and activities of daily living (ADL).
  
  
  METHODS
  The analysis was performed in the Italian Longitudinal Study on Aging (ILSA) sample, consisting of 5,632 individuals aged 65-84. The ILSA aims at major cardiovascular and neurological age-associated diseases. The baseline survey was performed in 1992 to detect prevalent diseases. The longitudinal examination started on September 1995 aiming at incidence, function and survival.
  
  
  RESULTS
  Complete follow-up data were achieved for 77% of the baseline stroke-free cohort (4,164 persons; 50.9% males; mean age 74.5 +/- 5.7 years). Incidence for first-ever stroke was 9.51 (95% CI: 7.75-11.27) per 1,000 person years and 12.99 (95% CI: 10.99-14.98) including recurrent stroke (total incidence). Crude mortality was 49.2% among first stroke patients and 15% among persons without stroke. The first-ever stroke mortality risk ratio, adjusted for demographics and comorbidity, was 2.40 (95% CI: 1.62-3.54). In survivors, impairment of at least one ADL was present in 67.6% of first-ever stroke patients vs. 31.6% of individuals without stroke. The comorbidity-adjusted OR was 2.63 (95% CI: 1.20-5.78) in the total cohort, and 4.00 (95% CI: 1.39-11.46) in individuals without disability at baseline.
  
  
  CONCLUSIONS
  The ILSA provides the first data on stroke incidence in Italy on a national basis. Overall, 153,000 new cases can be expected annually in the Italian elderly population. First-ever stroke still has a strong effect on survival and function of older persons.
authors.affiliation: Institute of Neurosciences, Italian National Research Council, Florence, Italy. dicarlo@area.fi.cnr.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Di Carlo
authors.forename: Marzia
authors.initials: M
authors.lastname: Baldereschi
authors.forename: Carlo
authors.initials: C
authors.lastname: Gandolfo
authors.forename: Livia
authors.initials: L
authors.lastname: Candelise
authors.forename: Augusto
authors.initials: A
authors.lastname: Ghetti
authors.forename: Stefania
authors.initials: S
authors.lastname: Maggi
authors.forename: Emanuele
authors.initials: E
authors.lastname: Scafato
authors.forename: Pierugo
authors.initials: P
authors.lastname: Carbonin
authors.forename: Luigi
authors.initials: L
authors.lastname: Amaducci
authors.forename: Domenico
authors.initials: D
authors.lastname: Inzitari
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D012737:Sex Factors; D012959:Socioeconomic Factors; D020521:Stroke / Q000150:complications* / Q000453:epidemiology* / Q000503:physiopathology; D015996:Survival Rate