COMPARISON OF STROKE FEATURES AND DISABILITY IN DAILY-LIFE IN PATIENTS WITH ISCHEMIC STROKE AGED 55 TO 70 AND 71 TO 85 YEARS

Background and Purpose This study compared stroke features and poststr oke disability in two age groups of patients with ischemic stroke: you nger (55 to 70 years) and older (71 to 85 years). Stroke has an impact on daily living in many areas, but whether risk factors, stroke featu res, and poststroke disability differ between young and old patients w ith stroke is not so well established. Methods A cohort of 486 ischemi c stroke patients aged 55 to 85 years admitted consecutively to the He lsinki University Central Hospital (Finland) between December 1, 1993, and March 31, 1995, were examined 3 months after the index stroke. St ructured medical, neurological, and radiological (MRI or CT) examinati ons, mental status, and emotional examination and interview of a close informant were done. Prestroke and poststroke activities of daily liv ing were assessed with five scales: the Index of ADL. Instrumental Act ivities of Daily Living Scale, Functional Activities Questionnaire; Bl essed Functional Activities Scale, and Barthel Index. Results History of cardiac failure (P < .001), atrial fibrillation (P < .001), and car dioembolic stroke (P = .011) was more frequent in the older age group, whereas stroke due to large-artery atherosclerosis (P = .048) was mor e common in the younger age group. The older patients more often had m ajor dominant stroke syndrome (P = .018). Comparison of activities of daily living before and after stroke showed that the older age group d eteriorated significantly more than the younger age group after adjust ment for sex, education, and living conditions (Barthel Index, P = .00 5; other scales, P < .0001). Conclusions The stroke patients in young and old age groups had different risk profiles and stroke features. Th e older stroke patients were more dependent and disabled beforehand, a nd after stroke they were relatively even more dependent than the pati ents in the younger age group. Because older patients already constitu te the majority of stroke victims, the importance of early active diag nosis, treatment, rehabilitation, and guidance is stressed.