Influence of cognitive impairment on the institutionalisation rate 3 years after a stroke.
OBJECTIVE
Pre-existing cognitive decline and new-onset dementia are common in patients with stroke, but their influence on institutionalisation rates is unknown.


OBJECTIVE
To evaluate the influence of cognitive impairment on the institutionalisation rate 3 years after a stroke.


METHODS
(1) The previous cognitive state of 192 consecutive patients with stroke living at home before the stroke (with the Informant Questionnaire on COgnitive Decline in the Elderly (IQCODE)), (2) new-onset dementia occurring within 3 years and (3) institutionalisation rates within 3 years in the 165 patients who were discharged alive after the acute stage were prospectively evaluated.


RESULTS
Independent predictors of institutionalisation over a 3-year period that were available at admission were age (adjusted odds ratio (adjOR) for 1-year increase = 1.08; 95% confidence interval (CI) 1.03 to 1.15), severity of the neurological deficit (adjOR for 1-point increase in Orgogozo score = 0.97; 95% CI 0.96 to 0.99) and severity of cognitive impairment (adjOR for 1-point increase in IQCODE score = 1.03; 95% CI 1 to 1.06). Factors associated with institutionalisation at 3 years that were present at admission or occurred during the follow-up were age (adjOR for 1-year increase = 1.17; 95% CI 1.07 to 1.27) and any (pre-existing or new) dementia (adjOR = 5.85; 95% CI 1.59 to 21.59), but not the severity of the deficit of the neurological deficit.


CONCLUSIONS
Age and cognitive impairment are more important predictors of institutionalisation 3 years after a stroke than the severity of the physical disability.
Pasquini
M
M
Department of Neurology (Stroke Unit), Lille University Hospital, Lille, France.
Leys
D
D
Rousseaux
M
M
Pasquier
F
F
Hénon
H
H
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000209:etiology* / Q000534:rehabilitation*; D003704:Dementia / Q000209:etiology / Q000534:rehabilitation; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000523:psychology; D000071939:Stroke Rehabilitation