CORRELATES OF DEPENDENT LIVING 3 MONTHS AFTER ISCHEMIC STROKE

To examine the correlates of dependent living after ischemic stroke, a consecutive cohort of 486 patients aged 55-85 years was examined 3 mo nths after the index stroke. Detailed medical, neurological and radiol ogical stroke evaluation, structured measures of cognition, emotion an d behavior, activities of daily living (ADL), physical disability, and assessment of dependent living were performed. Independent correlates of dependent living 3 months after stroke were the presence of the ma jor hemispheral stroke syndrome (odds ratio, OR, 11.8, 95% confidence interval, CI, 7.2-19.9), and a combination of handicap (Rankin Scale, OR 3.9, 95% CI 2.6-6.1), cognition (DSM-III-R dementia, OR 3.9, CI 1.5 -10.7; any cognitive decline, OR 4.5, CI 2.0-11.2), and ADL [Functiona l Activities Questionnaire (FAQ), OR 1.2, 95% CI 1.1-1.2]. The Rankin Scale explained 51.5%, FAQ 5.9% and presence of DSM-III-R dementia or any cognitive decline 3.4% of the total variance between dependent and independent patients after stroke. Independent of the effects of phys ical disability, presence of cognitive impairment has important functi onal consequences on stroke patients. Our findings emphasize the impor tance of the evaluation of cognitive functions in both observational a nd interventional clinical trials, as well as in treatment planning, r ehabilitation and guidance of patients with ischemic stroke.