From the Department of Rehabilitation Medicine, State University of New
York at Buffalo (G.E.G.); the Department of Neurology, School of Medicine,
Boston University (P.A.W., M.K.H., C.S.K.), the Section of Preventive Medicine
and Epidemiology, Evans Memorial Department of Clinical Research and
Department of Medicine, Boston Medical Center (P.A.W.), Boston University
School of Public Health (A.B.) and Department of Mathematics, Boston
University (R.B.D.), Boston, Mass; and The Framingham Study of the National
Heart, Lung, and Blood Institute, Framingham, Mass.
Correspondence to Glen E. Gresham, MD, Professor and Chairman, Department of Rehabilitation Medicine, State University of New York at Buffalo, Erie County Medical Center, 462 Grider St, Buffalo, NY 14215.
Background and Purpose—We examined
the 20-or-more-year survival and functional levels of 148 stroke
survivors and 148 age- and sex-matched control subjects from the
Framingham Study Cohort, whom we originally studied in 1972–1974 to
ascertain the survival and disability status of stroke survivors
compared with that of controls.
Methods—This long-term evaluation was done with use of data from
the 1993–1995 Framingham Study Cohort Examination 23 on the 10 stroke
survivors and 20 control subjects still living to identify and compare
the host characteristics and functional status of each group. The
survival curves for both stroke survivors and controls were derived
from the ongoing Framingham Study database.
Results—Twenty-plus-year stroke survivors experienced a greater
mortality than age- and sex-matched controls (92.5% and 81%,
respectively). The slopes of the two survival curves were essentially
the same. Functional status (eg, walking and independence in activities
of daily living) of stroke survivors, however, compared very favorably
with that of the control subjects. Stroke survivors were more likely to
be female and to have a number of comorbidities, including elevated
blood pressures, greater use of medications, less use of alcohol, and
less depressive symptomology.
Conclusions—In the Framingham cohort, 20-plus-year stroke
survivors showed greater mortality than age- and sex-matched control
subjects; functionally, however, the groups were very similar and in
general quite independent.
© 1998 American Heart Association, Inc.
Original Contributions
Survival and Functional Status 20 or More Years After First Stroke
The Framingham Study
Key Words: stroke outcome • mortality • follow-up studies • case-control studies • epidemiology
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