Auckland Stroke Outcomes Study. Part 1: Gender, stroke types, ethnicity, and functional outcomes 5 years poststroke.
BACKGROUND
Studying long-term stroke outcomes including body functioning (neurologic and neuropsychological impairments) and activity limitations and participation is essential for long-term evidence-based rehabilitation and service planning, resource allocation, and improving health outcomes in stroke. However, reliable data to address these issues is lacking.


METHODS
This study (February 2007-December 2008) sourced its participants from the population-based incidence study conducted in Auckland in 2002-2003. Participants completed structured self-administered questionnaires, and a face-to-face interview including a battery of neuropsychological tests. Logistic regression analysis was used to analyze associations between and within functional outcomes and their potential predictors.


RESULTS
Of 418 5-year stroke survivors, two-thirds had good functional outcome in terms of neurologic impairment and disability (defined as modified Rankin Score <3), 22.5% had cognitive impairment indicative of dementia, 20% had experienced a recurrent stroke, almost 15% were institutionalized, and 29.6% had symptoms suggesting depression. Highly significant correlations were found between and within various measurements of body functioning (especially neuropsychological impairments), activity, and participation. Age, dependency, and depression were independently associated with most outcomes analyzed.


CONCLUSIONS
The strong associations between neuropsychological impairment and other functional outcomes and across various measurements of body functioning, activity, and participation justify utilizing a multidisciplinary approach to studying and managing long-term stroke outcomes. Observed gender and ethnic differences in some important stroke outcomes warrant further investigations.
National Institute for Stroke and Applied Neurosciences, School of Rehabilitation and Occupation Studies, Faculty of Health and Environmental Studies, AUT University, AUT North Shore Campus, 90 Akoranga Dr., Auckland 1142, New Zealand. valery.feigin@aut.ac.nz
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Feigin
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Barker-Collo
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Parag
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Senior
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Lawes
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Ratnasabapathy
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Glen
D000368:Aged; D018672:Community Health Planning; D004185:Disability Evaluation; D005006:Ethnicity; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D009520:New Zealand / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000145:classification / Q000453:epidemiology / Q000208:ethnology; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D016896:Treatment Outcome