Stroke, Vol 25, 808-813, Copyright © 1994 by American Heart Association
H Nakayama, HS Jorgensen, HO Raaschou and TS Olsen
BACKGROUND AND PURPOSE: This study was undertaken to elucidate whether and
how age influences stroke outcome. METHODS: This prospective and
community-based study comprised 515 consecutive acute stroke patients.
Computed tomographic scan was performed in 79% of patients. Activities of
daily living (ADL) and neurological status were assessed weekly during
hospital stay using the Barthel Index (BI) and the Scandinavian Stroke
Scale (SSS), respectively. Information regarding social condition and
comorbidity before stroke was also registered. A multiple regression model
was used to analyze the independent influence of age on stroke outcome.
RESULTS: Age was not related to the type of stroke lesion or infarct size.
However, age independently influenced initial BI (-4 points per 10 years, P
< .01), initial SSS (-2 points per 10 years, P = .01), and discharge BI
(-3 points per 10 years, P < .01). No independent influence of age was
found regarding mortality within 3 months, discharge SSS, length of
hospital stay, and discharge placement. ADL improvement was influenced
independently by age (-3 points per 10 years, P < .01), whereas age had
no influence on neurological improvement or on speed of recovery.
CONCLUSIONS: Age independently influences stroke outcome selectively in
ADL-related aspects (BI) but not in neurological aspects (SSS), suggesting
a poorer compensatory ability in elderly stroke patients. Therefore,
rehabilitation of elderly stroke patients should be focused more on ADL and
compensation rather than on the recovery of neurological status, and age
itself should not be a selection criterion for rehabilitation.
ARTICLES
The influence of age on stroke outcome. The Copenhagen Stroke Study
Department of Neurology, Bispebjerg Hospital, Copenhagen, Denmark.
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