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Aim: This study investigated changes in functional status in home-dwelling stroke survivors 1-3 years after inpatient rehabilitation. It also examined the factors associated with longitudinal functional changes and health-related quality of life., Methods: Survey evaluations were conducted at the homes of 27 stroke survivors. The Functional Independence Measure (FIM), Short Form 36, Frenchay Activities Index, and Hamilton Depression Rating Scale were used to assess functional status, quality of life, social activity, and depression symptoms, respectively., Results: From the time of discharge to follow-up (mean: 2.1 ± 0.6 years), total FIM and motor FIM scores were mildly improved, and cognitive FIM score was significantly improved. On the Short Form 36, physical functioning, general health, and vitality scores were lower than norm-based scores. Multiple regression analyses showed a positive association between change in motor FIM score and Frenchay Activities Index score and a negative association between change in cognitive FIM score and elapsed time after discharge. With regard to health-related quality of life, motor FIM score was associated with the physical component summary, whereas age and Hamilton Depression Rating Scale score were associated with the mental component summary., Conclusion: Social participation was associated with long-term improvement in activities of daily living, indicating that interventions targeting social function are important for maintaining and further improving activities of daily living in stroke survivors. Health-related quality of life was correlated with activities of daily living and depression; therefore, interventions targeting these parameters are important in improving the quality of life of stroke survivors., (© 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.)

Background: As the population continues to age rapidly, clarifying the factors affecting the prognosis in very elderly stroke patients is essential to enhance the quality of their rehabilitation. Objectives: To compare the functional recovery of elderly stroke patients classified into three age groups and to identify the predictors of functional recovery in the very elderly following acute inpatient rehabilitation. Methods: Observational study: We collected data on 461 stroke patients in the neurology and neurosurgery ward and classified them into three age groups (65-74, 75-84, and ≥ 85 years). Functional recovery was compared among groups using the functional independence measure (FIM) at discharge and ADL recovery rate was compared using the Montebello rehabilitation factor score (MRFS). Multiple regression analysis was used to identify and compare the factors associated with functional recovery in each age group. Results: Functional recovery in the ≥ 85 years group was lower than that in other age groups. Factors associated with activities of daily living (ADL) status (FIM at discharge) in the ≥ 85 years group were premorbid dependence (β = -0.183, p = 0.011), motor paralysis (β = -0.238, p = 0.001), and cognitive function (β = 0.586, p < 0.001). Furthermore, the impact of cognitive function grew as age increased. Factors associated with ADL recovery rates (MRFS) in the ≥ 85 years group were non-paretic limb function (β = -0.294, p = 0.004) and cognitive function (β = 0.201, p = 0.047). Conclusions: This study identified the factors associated with functional recovery among very elderly stroke patients. Effective forms of rehabilitation for very elderly stroke patients that take these factors into consideration need to be investigated. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to investigate the long-term mortality, daily living activities, social activity, and symptoms of depression, in post-stroke patients discharged to their homes from a convalescent rehabilitation ward, and to determine the relationship between demographic variables and long-term outcome. Methods This study included 252 consecutive stroke patients (140 men; mean age, 72.4 ± 10.8 years) who had been admitted to a convalescent rehabilitation ward for inpatient rehabilitation. Follow-up assessment was made by postal questionnaire for up to >1 year after discharge, and included the modified Rankin scale, Frenchay activities index (FAI), and Geriatric Depression Scale. Results Of the 192 respondents (76.2%), 160 (83.3%) were living at home. Eighty-three (51.8%) were independent. Cumulative post-stroke mortality at 1 and 3 years was 3.7% and 19.4%, respectively.Mean total FAI score was 26.5 ± 10.9, suggesting that social inactivity was common. The estimated prevalence of depression was 21.6%. Coronary artery disease and motor functional independence measures were significantly associated with mortality, whereas age, recurrent stroke, severity of paralysis, and motor functional independence measures were significant predictors of independence. In the cross-sectional logistic model, depression symptoms were inversely associated with FAI score. Conclusions The mortality rate of patients discharged to their home following inpatient rehabilitation is relatively low. Social inactivity and depression symptoms, however, remain common during the chronic phase, and the severity of depression and restriction of participation were interrelated. [ABSTRACT FROM AUTHOR]