Abstract T P131: Racial Disparities in Post-Stroke Activity Limitations are not due to Pre-Stroke Activity Limitation Differences
Introduction: African Americans have higher stroke incidence and more long-term disability than whites, in spite of similar stroke severity. We sought to explore whether these differences may be due to differences in pre-stroke functioning.
Methods: Initiated in 1968, the Panel Study of Income Dynamics (PSID) is a nationally representative US panel survey of approximately 5,000 families and their descendants, including an oversample of African-American families. We studied all PSID household heads and spouses (about 12,000 individuals per year) who reported they had an incident stroke in the prior two-year period (directly or by proxy response) between 2001-2011. PSID queries difficulty with seven different self-care and mobility activities. Our primary outcome was an index representing the sum of total activity limitations (0-7). Racial differences in activity limitations were estimated using survey-weighted descriptive statistics for study waves before, with and after the wave when incident stroke was reported.
Results: A total of 534 incident strokes were identified, 198 (37%) in African-Americans who were younger (52.2 vs. 60.1, p < 0.001) and had more hypertension (57% vs. 42%, p < 0.01) and diabetes (23% vs. 14%, p < 0.01) than whites. In the wave prior to the stroke there was no racial difference in activity limitations. In the wave of the incident stroke (between 0-2 years from incident stroke), African Americans had considerably more activity limitations than whites, a difference that decreased over subsequent waves. (Figure) These changes persisted after adjusting for age, sex and comorbidities.
Conclusion: Racial disparities in stroke functional outcomes are not due to pre-stroke functional differences and most likely arise after stroke.
Author Disclosures: J.F. Burke: Research Grant; Significant; Dr. Burke is funded by NIH grants K08NS082597 and R01MD008879. L.E. Skolarus: Research Grant; Significant; Dr. Skolarus is supported by NIH grants K23NS073685, R01MD008879 and R21NS084081. V.A. Freedman: Research Grant; Significant; Dr. Freedman is supported by NIH grant P01AG029409 and an NSF grant ..
- © 2015 by American Heart Association, Inc.