Functional stroke recovery varies by age, sex, and stroke type

Following stroke, long-term recovery patterns in multifaceted functional domains differ by patient age, stroke severity, and stroke type, according to a study published online Sept. 23 in JAMA Network Open.

Seyoung Shin, M.D., from Sungkyunkwan University in Seoul, South Korea, and colleagues examined long-term changes in functional status and residual disability in survivors of first-time stroke. The analysis included 7,858 patients with first-time strokes treated at one of nine district hospitals (August 2012 to May 2015) with 60 months of follow-up.

The researchers found that overall, functions plateaued between 12 and 18 months after stroke and declined after 30 months (e.g., the mean Korean Mini-Mental State Examination improved from seven days to 12 months, plateaued until 36 months, and decreased from 36 months to 48 months). Interaction associations were seen between time after stroke and age, stroke severity, and stroke type in functional assessment outcomes.

For example, mean Fugl-Meyer Assessment (FMA) scores were higher at seven days and at six months for those aged 65 years and younger versus those older than 65 years and for ischemic versus hemorrhagic stroke. Mean FMA scores at six months was higher for mild versus moderate stroke and higher for moderate versus severe stroke. At 60 months, older age was associated with fewer activities of daily living independence, while male sex and hemorrhagic stroke type were associated with independence.

"Understanding the diversity of long-term functional recovery patterns and factors associated with these outcomes in survivors of stroke may help clinicians develop strategies for effective stroke care and rehabilitation," the authors write.

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