The disability burden associated with stroke emerges before stroke onset and differentially affects blacks: results from the health and retirement study cohort.

TitleThe disability burden associated with stroke emerges before stroke onset and differentially affects blacks: results from the health and retirement study cohort.
Publication TypeJournal Article
Year of Publication2014
AuthorsCapistrant, BD, Mejia, NI, Liu, SY, Wang, Q, M. Glymour, M
JournalJ Gerontol A Biol Sci Med Sci
Volume69
Issue7
Pagination860-70
Date Published2014 Jul
ISSN Number1758-535X
KeywordsActivities of Daily Living, African Americans, Aged, Aged, 80 and over, Aging, Cohort Studies, Disabled Persons, European Continental Ancestry Group, Female, Humans, Male, Prospective Studies, Stroke, United States
Abstract

BACKGROUND: Few longitudinal studies compare changes in instrumental activities of daily living (IADLs) among stroke-free adults to prospectively document IADL changes among adults who experience stroke. We contrast annual declines in IADL independence for older individuals who remain stroke free to those for individuals who experienced stroke. We also assess whether these patterns differ by sex, race, or Southern birthplace.

METHODS: Health and Retirement Study participants who were stroke free in 1998 (n = 17,741) were followed through 2010 (average follow-up = 8.9 years) for self- or proxy-reported stroke. We used logistic regressions to compare annual changes in odds of self-reported independence in six IADLs among those who remained stroke free throughout follow-up (n = 15,888), those who survived a stroke (n = 1,412), and those who had a stroke and did not survive to participate in another interview (n = 442). We present models adjusted for demographic and socioeconomic covariates and also stratified on sex, race, and Southern birthplace.

RESULTS: Compared with similar cohort members who remained stroke free, participants who developed stroke had faster declines in IADL independence and lower probability of IADL independence prior to stroke. After stroke, independence declined at an annual rate similar to those who did not have stroke. The black-white disparity in IADL independence narrowed poststroke.

CONCLUSION: Racial differences in IADL independence are apparent long before stroke onset. Poststroke differences in IADL independence largely reflect prestroke disparities.

URLhttp://biomedgerontology.oxfordjournals.org/content/early/2014/01/19/gerona.glt191.abstract
DOI10.1093/gerona/glt191
User Guide Notes

http://www.ncbi.nlm.nih.gov/pubmed/24444610?dopt=Abstract

Endnote Keywords

Minority aging/Disablement process/Stroke/Cardiovascular/Epidemiology.

Endnote ID

999999

Alternate JournalJ Gerontol A Biol Sci Med Sci
Citation Key7995
PubMed ID24444610
PubMed Central IDPMC4067116
Grant ListT32 NS048005 / NS / NINDS NIH HHS / United States
U01AG009740 / AG / NIA NIH HHS / United States
T32 HD007168 / HD / NICHD NIH HHS / United States
R21 AG034385 / AG / NIA NIH HHS / United States
R24 HD050924 / HD / NICHD NIH HHS / United States