title: Consequences of stroke in community-dwelling elderly: the health and retirement study, 1998 to 2008.
abstract: OBJECTIVE
  Stroke survivors are at risk of developing comorbidities that further reduce their quality of life. The purpose of this study was to determine the risk of developing a secondary health problem after stroke.
  
  
  METHODS
  We performed a case-control analysis using 6 biennial interview waves (1998 to 2008) of the Health and Retirement Study. We compared 631 noninstitutionalized individuals who had a single stroke with 631 control subjects matched for age, gender, and interview wave. We studied sleep problems, urinary incontinence, motor impairment, falls, and memory deficits among the 2 groups.
  
  
  RESULTS
  Stroke survivors frequently developed new or worsened motor impairment (33%), sleep problems (up to 33%), falls (30%), urinary incontinence (19%), and memory deficits (9%). As compared with control subjects, the risk of developing a secondary health problem was highest for memory deficits (OR, 2.45; 95% CI, 1.34 to 4.46) followed by urinary incontinence (OR, 1.86; 95% CI, 1.31 to 2.66), motor impairment (OR, 1.61; 95% CI, 1.16 to 2.24), falls (OR, 1.5; 95% CI, 1.12 to 2.0), and sleep disturbances (OR, 1.49; 95% CI, 1.09 to 2.03). In contrast, stroke survivors were not more likely to injure themselves during a fall (OR, 1.14; 95% CI, 0.72 to 1.79). After adjusting for cardiovascular risk factors, social status, psychiatric symptoms, and pain, the risks of falling or developing sleep problems were not different from the control subjects.
  
  
  CONCLUSIONS
  The risk of developing a secondary health problem that can impact daily life is markedly increased after stroke. A better understanding of frequencies and risks for secondary health problems after stroke is necessary for designing better preventive and rehabilitation strategies.
authors: University of Minnesota, Department of Neurology, MMC 295, 420 Delaware Street SE, Minneapolis, MN 55455, USA. divani@umn.edu
authors: Afshin A
authors: AA
authors: Divani
authors: Shahram
authors: S
authors: Majidi
authors: Anna M
authors: AM
authors: Barrett
authors: Siamak
authors: S
authors: Noorbaloochi
authors: Andreas R
authors: AR
authors: Luft
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