The influence of gender and age on disability following ischemic stroke: the Framingham study.
The influence of gender and age on disability following ischemic stroke: the Framingham study.
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DOI：
10.1016/s1052-3057(03)00042-9
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发表时间：
2003-05-01
期刊：
影响因子：
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通讯作者：
Wolf, Philip A
中科院分区：
文献类型：
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作者：
Kelly-Hayes, Margaret;Beiser, Alexa;Wolf, Philip A
老年中风幸存者的残疾程度是相当大的。很少有基于社区的关于性别和年龄对卒中相关残疾和结果的贡献的估计。使用最初的弗雷明汉研究队列，我们记录了中风幸存者在中风后6个月的性别特异性神经功能缺陷和残疾差异。进行逻辑回归分析以估计优势比，比较男性和女性，并调整年龄、年龄和中风亚型。然后比较年龄和性别匹配的对照，以区分与中风相关的残疾和与一般衰老相关的残疾。结果显示，该队列中几乎一半（43%）的老年中风幸存者有中度至重度神经功能障碍。在粗略分析中，女性更依赖adl(33.9%对15.6%)，不太可能独立行走（40.3%对17.8%），住在养老院（34.9%对13.3%）。在对年龄和中风亚型进行调整后，年龄较大才是导致残疾严重程度的原因。与年龄和性别匹配的对照组相比，中风患者在所有研究领域的残疾程度都明显更高。在这个老年队列中，更多的女性经历了最初的中风，并且在中风后6个月残疾的人数多于男性。然而，中风发病年龄越大，与残疾程度越高有关，而与性别或中风亚型无关。卫生保健提供者需要了解，中风发生在妇女生命的后期，而且由于年龄的原因，妇女残疾和住院的风险更大。
The magnitude of disability among elderly stroke survivors is substantial. There have been few community-based estimates of the contribution gender and older age make to stroke-related disability and outcome. Using the original Framingham Study cohort, we documented gender-specific neurological deficits and disability differences in stroke survivors at six months post-stroke. Logistic regression analyses were performed to estimate odds ratios, comparing men and women, and adjusting for age, and age and stroke subtype. Age and gender-matched controls were then compared to distinguish stroke-related disability from disability associated with general aging. Results showed that almost half (43%) of all elderly stroke survivors in the cohort had moderate to severe neurological deficits. In the crude analyses, women were more dependent in ADLs (33.9% vs 15.6%), less likely to walk unassisted (40.3% vs 17.8%), and living in nursing homes (34.9 % vs 13.3%). After adjusting for age and stroke subtype, it was older age that accounted for the severity of disability. When compared to age and gender-matched controls, stroke cases were significantly more disabled in all domains studied. In this elderly cohort, more women experienced initial strokes and were more disabled at 6 months post-stroke than men. However, older age at stroke onset, not gender or stroke subtype, was associated with greater disability. Health care providers need to understand that strokes occur later in life for women and that because of age, women are at greater risk for disability and institutionalization.