School of Public Health, Georgia State University, USA.
Global Health Research Center, Duke Kunshan University, China; Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, China.
Disabil Health J. 2023 Jul;16(3):101452. doi: 10.1016/j.dhjo.2023.101452. Epub 2023 Feb 24.
Differences in activity limitations between stroke survivors and people with other chronic conditions and how their levels of activity limitation vary by sociodemographic characteristics have not been well quantified.
To quantify activity limitations experienced by Chinese older adult stroke survivors and explore stroke effects in specific subgroups.
We used Chinese Longitudinal Healthy Longevity Survey 2017-2018 data (N = 11,743) to produce population-weighted estimates of activity limitations using the Activities of Daily Living (ADL) and the Instrumental ADL (IADL) scales for older adults (age 65 and older) stroke survivors compared to those with non-stroke chronic conditions and those without chronic conditions. Multinomial logistic regressions were run with outcomes "no activity limitation," "IADL only limitation," and "ADL limitation."
The weighted marginal prevalence of ADL limitation was higher in the stroke group (14.8%) than in those with non-stroke chronic condition (4.8%) or no chronic conditions (3.6%) (p < 0.01). The corresponding prevalence of IADL limitation for the three groups was 36.0%, 31.4%, and 22.2%, respectively (p < 0.01). Stroke survivors aged ≥ 80 years had a higher prevalence of ADL/IADL limitation than those aged 65-79 years (p < 0.01). Formal education was associated with a lower prevalence of ADL/IADL limitation in each chronic condition group (p < 0.01).
Prevalence and severity of activity limitation among Chinese older adult stroke survivors were several times higher than those without chronic conditions and those with non-stroke chronic conditions. Stroke survivors, particularly those aged ≥80 years and those without formal education, might be predisposed to more severe activity limitation and require more support to compensate.
脑卒中幸存者与其他慢性病患者的活动受限程度存在差异,其活动受限水平随社会人口特征的变化而变化,但这些差异尚未得到充分量化。
量化中国老年脑卒中幸存者的活动受限程度,并探讨其在特定亚组中的影响。
我们使用中国健康长寿纵向研究 2017-2018 年的数据(N=11743),使用日常生活活动(ADL)和工具性日常生活活动(IADL)量表,对老年脑卒中幸存者(年龄≥65 岁)与非脑卒中慢性病患者和无慢性病患者进行人群加权估计,以评估其活动受限程度。采用多分类逻辑回归分析,以“无活动受限”、“仅有 IADL 受限”和“ADL 受限”为结局。
脑卒中组 ADL 受限的加权边际患病率(14.8%)高于非脑卒中慢性病组(4.8%)和无慢性病组(3.6%)(p<0.01)。三组的 IADL 受限患病率分别为 36.0%、31.4%和 22.2%(p<0.01)。≥80 岁的脑卒中幸存者 ADL/IADL 受限的患病率高于 65-79 岁者(p<0.01)。在每个慢性病组中,受正规教育程度与 ADL/IADL 受限的低患病率相关(p<0.01)。
中国老年脑卒中幸存者的活动受限发生率和严重程度是无慢性病和非脑卒中慢性病患者的数倍。≥80 岁且未接受正规教育的脑卒中幸存者可能更容易出现严重的活动受限,需要更多的支持来进行代偿。