Ruksakulpiwat Suebsarn, Zhou Wendie, Phianhasin Lalipat, Benjasirisan Chitchanok, Salehizadeh Saeideh, Wang Limin, Voss Joachim G
Department of Medical Nursing, Faculty of Nursing Mahidol University Bangkok Thailand.
School of Nursing Peking University Beijing China.
Chronic Dis Transl Med. 2023 Feb 21;9(2):164-176. doi: 10.1002/cdt3.60. eCollection 2023 Jun.
Stroke is the leading cause of mortality. This study aimed to investigate the association between stroke, comorbidities, and activity of daily living (ADL) among older adults in the United States.
Participants were 1165 older adults aged 60 and older from two waves (2016 and 2018) of the Health and Retirement Study who had a stroke. Descriptive statistics were used to describe demographic information and comorbidities. Logistic regressions and multiple regression analyses were used to determine associations between stroke, comorbidities, and ADL.
The mean age was 75.32 ± 9.5 years, and 55.6% were female. An adjusted analysis shows that older stroke adults living with diabetes as comorbidity are significantly associated with difficulty in dressing, walking, bedding, and toileting. Moreover, depression was significantly associated with difficulty in dressing, walking, bathing, eating, and bedding. At the same time, heart conditions and hypertension as comorbidity were rarely associated with difficulty in ADL. After adjusting for age and sex, heart condition and depression are significantly associated with seeing a doctor for stroke (odds ratio [OR]: 0.66; 95% confidence interval [CI]: 0.49-0.91; = 0.01) and stroke therapy (OR: 0.46; 95% CI: 0.25-0.84; = 0.01). Finally, stroke problem (unstandardized [] = 0.58, = 0.017) and stroke therapy ( = 1.42, < 0.001) significantly predict a lower level of independence.
This study could benefit healthcare professionals in developing further interventions to improve older stroke adults' lives, especially those with a high level of dependence.
中风是主要的致死原因。本研究旨在调查美国老年人中风、合并症与日常生活活动(ADL)之间的关联。
参与者为来自健康与退休研究两期(2016年和2018年)的1165名60岁及以上的中风老年人。描述性统计用于描述人口统计学信息和合并症。逻辑回归和多元回归分析用于确定中风、合并症与ADL之间的关联。
平均年龄为75.32±9.5岁,55.6%为女性。一项校正分析显示,患有糖尿病合并症的老年中风患者在穿衣、行走、整理床铺和如厕方面存在显著困难。此外,抑郁症与穿衣、行走、洗澡、进食和整理床铺困难显著相关。同时,合并心脏病和高血压与ADL困难很少相关。在校正年龄和性别后,心脏病和抑郁症与因中风就医(优势比[OR]:0.66;95%置信区间[CI]:0.49 - 0.91;P = 0.01)和中风治疗(OR:0.46;95% CI:0.25 - 0.84;P = 0.01)显著相关。最后,中风问题(未标准化β = 0.58,P = 0.017)和中风治疗(β = 1.42,P < 0.001)显著预测较低的独立水平。
本研究可为医疗保健专业人员制定进一步干预措施提供帮助,以改善老年中风患者的生活,尤其是那些依赖性较高的患者。