title: Effect of obesity on functional outcomes at 6 months post-stroke among elderly Koreans: a prospective multicentre study.
abstract: OBJECTIVE
  We examined whether obesity based on body mass index (BMI) was a predictor of functional independence measure (FIM) at 6 months after ischaemic stroke onset while adjusting for stroke risk factors and covariates and stratifying by age group.
  
  
  METHODS
  This is an interim report of the Korean Stroke Cohort for Functioning and Rehabilitation that was designed as a nested case study within a nationwide hospital-based cohort.
  
  
  METHODS
  We identified all patients who were admitted to nine representative hospitals in Korea from 2012 until 2014 under a diagnosis of acute first-ever ischaemic stroke. The hospitals were selected from the metropolitan district, mid-sized cities and a small-sized city.
  
  
  METHODS
  The sample included 2057 patients with acute ischaemic stroke who were at least 18 years old.
  
  
  METHODS
  We divided participants into two age levels (<65 and ≥ 65 years). Participants were classified into five groups according to their baseline BMI at admission: underweight (BMI<18.5), normal (18.5 ≤ BMI<23), overweight (23 ≤ BMI<25), obese (25 ≤ BMI<30) and extremely obese (30 ≤ BMI).
  
  
  RESULTS
  The proportion of patients who were aged ≥ 65 years was 55.0%. The proportions of underweight, normal, overweight, obese and extremely obese patients were 2.6%, 24.3%, 29.6%, 37.2% and 6.3%, respectively, in the <65 years group and 5.5%, 34.5%, 27.9%, 28.8% and 3.3%, respectively, in the ≥ 65 years group. In a multiple linear regression, the 6-month FIM after stroke in the elderly group was significantly associated with being extremely obese (7.95, p<0.05) after adjusting for confounding variables. In the <65 years group, the 6-month FIM was not associated with any weight category.
  
  
  CONCLUSIONS
  This nationwide hospital-based cohort study showed that extreme obesity is a predictor of a good 6-month FIM, especially in patients with ischaemic stroke who are at least 65 years of age.
authors.affiliation: Heart Vascular Stroke Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Korea.
authors.forename: Shin Yi
authors.initials: SY
authors.lastname: Jang
authors.affiliation: Department of Rehabilitation Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Pusan, Korea.
authors.forename: Yong-Il
authors.initials: YI
authors.lastname: Shin
authors.affiliation: Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Deog Young
authors.initials: DY
authors.lastname: Kim
authors.affiliation: Department of Rehabilitation Medicine, School of Medicine, Chungnam National University, Daejeon, Korea.
authors.forename: Min Kyun
authors.initials: MK
authors.lastname: Sohn
authors.affiliation: Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea.
authors.forename: Jongmin
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Physical and Rehabilitation Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Sam-Gyu
authors.initials: SG
authors.lastname: Lee
authors.affiliation: Department of Preventive Medicine, Wonkwang University School of Medicine, Iksan, Korea.
authors.forename: Gyung-Jae
authors.initials: GJ
authors.lastname: Oh
authors.affiliation: Department of Rehabilitation Medicine, Kyungpook National University School of Medicine, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Yang-Soo
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Department of Rehabilitation Medicine, Wonkwang University School of Medicine, Iksan, Korea.
authors.forename: Min Cheol
authors.initials: MC
authors.lastname: Joo
authors.affiliation: Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University, School of Medicine, Jeju, Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Han
authors.affiliation: Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Won Hyuk
authors.initials: WH
authors.lastname: Chang
authors.affiliation: Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Chung
authors.initials: C
authors.lastname: Kang
authors.affiliation: Heart Vascular Stroke Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Korea Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Yun-Hee
authors.initials: YH
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000175:diagnosis; D011446:Prospective Studies; D020127:Recovery of Function; D056910:Republic of Korea; D012307:Risk Factors; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D055815:Young Adult
keywords: body mass index; elderly; functional independence measure; ischemic stroke; obese