title: Correlates of functional outcome among stroke survivors in a developing country--a prospective community-based study from India.
abstract: Stroke survivors (SS) are rising with higher incidence of stroke in developing countries. In addition to physical impairment, other factors such as cognition, social interaction, and depression determine the functional outcome after stroke. Considering the paucity of data from developing countries, we planned to determine the change in various functional parameters among SS. This community-based prospective study was carried out in Kolkata, India among 283 SS between 2006 and 2010. Functional outcome was assessed at baseline and at 3 annual follow-up visits using validated tools. A stepwise regression analysis was performed with demographic and stroke-related covariates against various measures of functional outcome. Result showed that mean Barthel Index score at baseline was 76.4 ± 30.8. Bengali version of mental status examination and Geriatric Depression Scale scores trended down over time with a negative regression coefficient of -.2061 (standard error [SE], .0937) and -.4488 (SE, .2145). Other outcomes did not change. Female gender, depression, and cognitive dysfunction had an unfavorable impact, whereas education correlated positively. In conclusions female gender and neuropsychiatric disturbances showed poor functional outcome compared with education, which correlates with better outcome. This information will be helpful for patients in developing countries for planning stroke rehabilitation.
authors.affiliation: Department of Psychiatry, Medical College, Kolkata, India.
authors.forename: Malay Kumar
authors.initials: MK
authors.lastname: Ghosal
authors.affiliation: Department of Biostatistics, University of California, Davis, California.
authors.forename: Prabir
authors.initials: P
authors.lastname: Burman
authors.affiliation: Department of Neurology, University of California at San Francisco, San Francisco, California.
authors.forename: Vineeta
authors.initials: V
authors.lastname: Singh
authors.affiliation: Department of Neurology, Bangur Institute of Neuroscience (BIN), Kolkata, India.
authors.forename: Sujata
authors.initials: S
authors.lastname: Das
authors.affiliation: Department of Psychiatry, Institute of Post Graduate Medical Education & Research (IPGME&R), Kolkata, India.
authors.forename: Neelanjana
authors.initials: N
authors.lastname: Paul
authors.affiliation: Department of Neurology, Bangur Institute of Neuroscience (BIN) and Institute of Post Graduate Medical Education & Research (IPGME&R), Kolkata, India.
authors.forename: Biman Kanti
authors.initials: BK
authors.lastname: Ray
authors.affiliation: Department of Pharmacology, Institute of Post Graduate Medical Education & Research (IPGME&R), Kolkata, India.
authors.forename: Avijit
authors.initials: A
authors.lastname: Hazra
authors.affiliation: Department of Neurology, National Neuroscience Centre, Kolkata, India.
authors.forename: Tapas Kumar
authors.initials: TK
authors.lastname: Banerjee
authors.affiliation: School of Health Sciences, University of Canterbury, Christchurch, New Zealand.
authors.forename: Arindam
authors.initials: A
authors.lastname: Basu
authors.affiliation: Sampling Unit, Indian Statistical Institute, Kolkata, India.
authors.forename: Arijit
authors.initials: A
authors.lastname: Chaudhuri
authors.affiliation: Department of Pharmacology, Institute of Post Graduate Medical Education & Research (IPGME&R), Kolkata, India. Electronic address: das_sk70@hotmail.com.
authors.forename: Shyamal Kumar
authors.initials: SK
authors.lastname: Das
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D003863:Depression / Q000523:psychology*; D003906:Developing Countries / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards; D011446:Prospective Studies; D012044:Regression Analysis; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology* / Q000523:psychology*; D017741:Survivors / Q000523:psychology*
keywords: Developing country; cognition; depression; physical disability; stroke; stroke survivor