title: Neurological, functional, and cognitive stroke outcomes in Mexican Americans.
abstract: OBJECTIVE
  Our objective was to compare neurological, functional, and cognitive stroke outcomes in Mexican Americans (MAs) and non-Hispanic whites using data from a population-based study.
  
  
  METHODS
  Ischemic strokes (2008-2012) were identified from the Brain Attack Surveillance in Corpus Christi (BASIC) Project. Data were collected from patient or proxy interviews (conducted at baseline and 90 days poststroke) and medical records. Ethnic differences in neurological (National Institutes of Health Stroke Scale: range, 0-44; higher scores worse), functional (activities of daily living/instrumental activities of daily living score: range, 1-4; higher scores worse), and cognitive (Modified Mini-Mental State Examination: range, 0-100; lower scores worse) outcomes were assessed with Tobit or linear regression adjusted for demographics and clinical factors.
  
  
  RESULTS
  A total of 513, 510, and 415 subjects had complete data for neurological, functional, and cognitive outcomes and covariates, respectively. Median age was 66 (interquartile range, 57-78); 64% were MAs. In MAs, median National Institutes of Health Stroke Scale, activities of daily living/instrumental activities of daily living, and Modified Mini-Mental State Examination score were 3 (interquartile range, 1-6), 2.5 (interquartile range, 1.6-3.5), and 88 (interquartile range, 76-94), respectively. MAs scored 48% worse (95% CI, 23%-78%) on National Institutes of Health Stroke Scale, 0.36 points worse (95% CI, 0.16-0.57) on activities of daily living/instrumental activities of daily living score, and 3.39 points worse (95% CI, 0.35-6.43) on Modified Mini-Mental State Examination than non-Hispanic whites after multivariable adjustment.
  
  
  CONCLUSIONS
  MAs scored worse than non-Hispanic whites on all outcomes after adjustment for confounding factors; differences were only partially explained by ethnic differences in survival. These findings in combination with the increased stroke risk in MAs suggest that the public health burden of stroke in this growing population is substantial.
authors.affiliation: From the Departments of Epidemiology (L.D.L., L.B.M.) and Biostatistics (B.N.S., J.B.), University of Michigan School of Public Health, Ann Arbor; and Stroke Program, University of Michigan Health System, Ann Arbor (L.D.L., L.E.S., M.A.S., N.G., D.L.B., L.B.M.).
authors.forename: Lynda D
authors.initials: LD
authors.lastname: Lisabeth
authors.forename: Brisa N
authors.initials: BN
authors.lastname: Sánchez
authors.forename: Jonggyu
authors.initials: J
authors.lastname: Baek
authors.forename: Lesli E
authors.initials: LE
authors.lastname: Skolarus
authors.forename: Melinda A
authors.initials: MA
authors.lastname: Smith
authors.forename: Nelda
authors.initials: N
authors.lastname: Garcia
authors.forename: Devin L
authors.initials: DL
authors.lastname: Brown
authors.forename: Lewis B
authors.initials: LB
authors.lastname: Morgenstern
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000208:ethnology* / Q000401:mortality / Q000503:physiopathology*; D003704:Dementia / Q000208:ethnology / Q000401:mortality / Q000503:physiopathology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data*; D008875:Middle Aged; D009483:Neuropsychological Tests; D020127:Recovery of Function / Q000502:physiology*; D012307:Risk Factors; D020521:Stroke / Q000208:ethnology* / Q000401:mortality / Q000503:physiopathology*; D013781:Texas / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
keywords: ethnicity; patient outcome assessment; stroke