Disability Trajectories Steeper after Stroke

A population-based, prospective cohort study revealed that a trajectory of increasing disability became significantly steeper after stroke but not after myocardial infarction (MI). The study included 5888 individuals 65 years or older from 1989 to 2013, mean age was 72.8 years; 2495 were male. During a mean follow-up of 13 years, 382 participants had ischemic stroke and 395 had MI with 1 or more disability assessment after the event. The increase in disability near the time of the event was greater for stroke (0.88 points on the disability scale) than MI (0.20 points on the disability scale). The annual increase in disability before stroke (0.06 points per year) more than tripled after stroke (0.15 additional points per year). The annual increase in disability before MI (0.04 points per year) did not change significantly after MI (0.02 additional points per year). The findings suggest that in addition to the acute brain injury and consequent impairment, ischemic stroke may also be associated with potentially treatable long-term adverse effects on the brain that lead to accelerated functional decline. Source: https://jamanetwork.com/