HEALTH-STATUS OF INDIVIDUALS WITH MILD STROKE

Background and Purpose Diminished quality of life and limitations in h igher levels of physical functioning are often underestimated in strok e and are not fully captured by measures such as the Barthel Index and the Rankin Outcome Scale. This study used additional measures to asse ss the health status of 304 persons with mild stroke and to compare th ese individuals with 184 persons with transient ischemic attack and 65 4 persons without history of stroke/transient ischemic attack but at e levated risk for stroke (asymptomatic group). Methods Subjects were re cruited from the Academic Medical Center Consortium (inpatients), the Cardiovascular Health Study (population-based sample of community-dwel ling persons 65 years and older), and United HealthCare (inpatients an d outpatients typically younger than 65 years). Subjects were intervie wed by telephone or in person to assess activities of daily living (Ba rthel Index), depression (Center for Epidemiological Studies Depressio n Scale), health status (MOS-36), and utility for current health state . Results Most respondents were independent an all Barthel items. The stroke group was more impaired on the MOS-36 than the asymptomatic gro up but similar to the group with transient ischemic attack. Health-rel ated quality of life was lowest for persons with stroke. While symptom status and Barthel Index score were the strongest predictors of healt h status, the Barthel Index showed a consistent ceiling effect when co mpared with the physical function subscale of the MOS-36. Conclusions The consequences of even mild stroke affect all dimensions of health e xcept pain. Standardized assessment of persons with stroke must evalua te across the entire continuum of health-related functions.