J Clin Neurol.  2005 Apr;1(1):59-68. 10.3988/jcn.2005.1.1.59.

Factors Affecting the Quality of Life After Ischemic Stroke: Young Versus Old Patients

Affiliations
  • 1Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. jongskim@amc.seoul.kr
  • 2College of Nursing, Seoul National University, Seoul, Korea.
  • 3College of Nursing, Nutrition, Kaya University, Kyungbuk, Korea.

Abstract

BACKGROUND
Factors affecting the quality of life (QOL) may be different between young and old stroke patients. However, these issues have not yet been properly investigated.
METHODS
We identified 170 young-onset stroke patients (onset between 15 and 45 years of age) who were admitted to the Asan Medical Center. Three hundred and forty follow-up period matched, old-onset stroke patients (onset >45 years of age) were chosen as a control group. A follow-up interview was performed 1~5 years after the onset of stroke in 96 young patients and 160 old patients. With the use of standardized questionnaire, we assessed physical disabilities, activity of daily living (Barthel Index Score, modified Rankin scale), the presence of depression (using DSM IV criteria and Beck Depression Inventory) and socio-economic/job status. The QOL was assessed using the Stroke Specific QOL developed by Williams et al.
RESULTS
The QOL scores were significantly higher in young patients than in old ones. Univariate analysis showed that factors related to low QOL included unemployment, motor impairment, aphasia, dysarthria, dysaphagia and severe modified Rankin score in young patients while poor economic status, unemployment, supratentorial (vs. infratentorial) stroke, anterior (vs. posterior) circulation stroke, the presence of diabetes mellitus, motor impairment, aphasia, dysarthria, dysphagia, visual field defect, severe modified Rankin score, the presence of post-stroke seizures and depression were related to the low QOL in old patients. Cigarette smoking (in old patients) and alcohol drinking (in both young and old patients) were related to high QOL. Multiple regression analysis showed that modified Rankin score was the most important factor explaining low QOL in both groups, while other important factors included depression, visual field defect and anterior circulation stroke in old patients, and the motor dysfunction and dysarthria in young patients.
CONCLUSIONS
We conclude that aside from modified Rankin scale, factors affecting the quality of life are different between these two groups. Recognition of these differences may allow us to develop different strategies to improve the quality of life in stroke patients.

Keyword

Cerebrovascular disease; Quality of life; Young; Age

MeSH Terms

Alcohol Drinking
Aphasia
Chungcheongnam-do
Deglutition Disorders
Depression
Diabetes Mellitus
Dysarthria
Follow-Up Studies
Humans
Quality of Life*
Seizures
Smoking
Stroke*
Unemployment
Visual Fields
Surveys and Questionnaires

Cited by  3 articles

Factors that Affect the Quality of Life at 3 Years Post-Stroke
Smi Choi-Kwon, Ji M. Choi, Sun U. Kwon, Dong-Wha Kang, Jong S. Kim
J Clin Neurol. 2006;2(1):34-41.    doi: 10.3988/jcn.2006.2.1.34.

Cost-Effectiveness of Recombinant Tissue Plasminogen Activator in the Management of Acute Ischemic Stroke: A Systematic Review
Kee-Taig Jung, Dong Wook Shin, Kyung-Jin Lee, Myungju Oh
J Clin Neurol. 2010;6(3):117-126.    doi: 10.3988/jcn.2010.6.3.117.

Factors Associated to Returning Home in the First Year after Stroke
Seung Han Kim, Yong-Il Shin, Seung Chan Kim, Sung Hwa Ko, Deog Young Kim, Jongmin Lee, Min Kyun Sohn, Sam-Gyu Lee, Gyung-Jae Oh, Yang-Soo Lee, Min Cheol Joo, Eun Young Han, Junhee Han, Won Hyuk Chang, Ji Hong Min, Yun-Hee Kim
Brain Neurorehabil. 2020;13(1):.    doi: 10.12786/bn.2020.13.e1.


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