Correlates of Functional Outcome among Stroke Survivors in a Developing Country–A Prospective Community-based Study from India

• Published in: Journal of stroke and cerebrovascular diseases Vol. 23; no. 10; pp. 2614 - 2621
• Main Authors: Ghosal, Malay Kumar, MD, Burman, Prabir, PhD, Singh, Vineeta, MD, Das, Sujata, PhD, Paul, Neelanjana, MD, Ray, Biman Kanti, DM, Hazra, Avijit, MD, Banerjee, Tapas Kumar, FRCP, Basu, Arindam, MD, MPH, PhD, Chaudhuri, Arijit, PhD, Das, Shyamal Kumar, DM
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2014
• Subjects: Aged; Aged, 80 and over; Cardiovascular; Cognition; depression; Depression - psychology; Developing Countries - statistics & numerical data; Developing country; Female; Humans; India - epidemiology; Male; Middle Aged; Neurology; Neuropsychological Tests - standards; physical disability; Prospective Studies; Regression Analysis; Sex Factors; stroke; Stroke - epidemiology; Stroke - psychology; stroke survivor; Survivors - psychology; India; stroke survivor; depression; cognition; stroke; Developing country; physical disability
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2014.06.001

Stroke survivors (SS) are rising with higher incidence of stroke in developing countries. In addition to physical impairment, other factors such as cognition, social interaction, and depression determine the functional outcome after stroke. Considering the paucity of data from developing countries, we planned to determine the change in various functional parameters among SS. This community-based prospective study was carried out in Kolkata, India among 283 SS between 2006 and 2010. Functional outcome was assessed at baseline and at 3 annual follow-up visits using validated tools. A stepwise regression analysis was performed with demographic and stroke-related covariates against various measures of functional outcome. Result showed that mean Barthel Index score at baseline was 76.4 ± 30.8. Bengali version of mental status examination and Geriatric Depression Scale scores trended down over time with a negative regression coefficient of −.2061 (standard error [SE], .0937) and −.4488 (SE, .2145). Other outcomes did not change. Female gender, depression, and cognitive dysfunction had an unfavorable impact, whereas education correlated positively. In conclusions female gender and neuropsychiatric disturbances showed poor functional outcome compared with education, which correlates with better outcome. This information will be helpful for patients in developing countries for planning stroke rehabilitation.