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19-01-2012 | Stroke | Article

Older age hinders stroke recovery

Abstract

Free abstract

MedWire News: The older patients are when they have an ischemic stroke, the smaller are their chances of making a good functional recovery, show registry data.

The effect was significant even in younger patients (those aged 55 years or less), although the impact of age was much greater in those older than 75 years, report Michael Knoflach (Innsbruck Medical University, Austria) and colleagues.

The team's conclusions are based on data from 14,256 ischemic stroke patients enrolled in the Austrian Stroke Unit Registry, 2223 of whom were aged 55 years or younger.

Most of the younger patients had good outcomes, with 92.1% of those aged 18-45 years and 88.2% of those aged 18-55 years achieving a good functional outcome, defined as a modified Rankin Scale (mRS) score of 2 or less at 3 months.

"These data, however, have to be interpreted in light of several reports suggesting persistently reduced quality of life and high frequency of fatigue after ischemic stroke in individuals in this age range," Knoflach et al comment in Neurology.

They add: "This discrepancy was also reported for patients with subarachnoid hemorrhage and probably reflects persistent deficits not captured by the mRS such as mood disturbances and cognitive dysfunction."

Up to the age of 75 years, the likelihood of patients achieving a good functional outcome declined by 3.1-4.2% with each decade increase in their ages. This was independent of factors including age, gender, stroke severity, pre-existing disability, and whether the patients underwent thrombolysis.

The effect was consistent for men and women, patients with and without diabetes, and those treated or not treated with thrombolysis.

After the age of 75 years, patients' chances of making a good recovery fell by about 10% per decade increase in age.

"The steep decline in the probability of good outcome in elderly individuals may partly reflect the rapidly increasing frequency of poststroke cognitive deficits and dementia at higher ages," suggest the researchers.

MedWire (http://www.medwire-news.md/) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Eleanor McDermid