ObjectiveThere were two main objectives: to describe and compare clinical outcomes and Patient-Reported Outcome Measures (PROMs) collected using standardised procedures across the European Registers of Stroke (EROS) at 3 and 12 months after stroke; and to examine the relationship between patients’ Health-Related Quality of Life (HRQoL) at 3 months after stroke and survival up to 1 year across the 5 populations.DesignAnalysis of data from population-based stroke registers.SettingEuropean populations in Dijon (France); Kaunas (Lithuania); London (UK); Warsaw (Poland) and Sesto Fiorentino (Italy).ParticipantsPatients with ischaemic or intracerebral haemorrhage (ICH) stroke, registered between 2004 and 2006.Outcome measures(1) HRQoL, assessed by the physical component summary (PCS) and mental component summary (MCS) of the Short-Form Health Survey (SF-12), mapped into the EQ-5D to estimate responses on 5 dimensions (mobility, activity, pain, anxiety and depression, and self-care) and utility scores. (2) Mortality within 3 months and within 1 year of stroke.ResultsOf 1848 patients, 325 were lost to follow-up and 500 died within a year of stroke. Significant differences in mortality, HRQoL and utility scores were found, and remained after adjustments. Kaunas had an increased risk of death; OR 2.34, 95% CI (1.32 to 4.14) at 3 months after stroke in Kaunas, compared with London. Sesto Fiorentino had the highest adjusted PCS: 43.54 (SD=0.96), and Dijon had the lowest adjusted MCS: 38.67 (SD=0.67). There are strong associations between levels of the EQ-5D at 3 months and survival within the year. The trend across levels suggests a dose–response relationship.ConclusionsThe study demonstrated significant variations in survival, HRQoL and utilities across populations that could not be explained by stroke severity and sociodemographic factors. Strong associations between HRQoL at 3 months and survival to 1 year after stroke were identified.

Objectives The purpose of this study was to identify the main dietary patterns in Lithuanian urban population and to determine their association with socio-demographic factors. Methods Data from the survey performed in the framework of the HAPIEE (Health, Alcohol, Psychosocial factors in Eastern Europe) study were presented. A random sample of 7087 individuals aged 45-72 years was screened in 2006-2008. Results Factor analysis of the main dietary patterns revealed five-factor solution which accounted 47.8 % of the variance: “fresh vegetables and fruit” “sweets” “porridge and cereals” “potatoes, meat, boiled vegetables and eggs” “chicken and fish”. “Fresh vegetables and fruits” factor and “sweets” factor were inversely associated with age both in men and women: older people consumed less frequent than average of particular food groups. Dietary patterns of people with good self-rated health and university education were healthier than among people with lower education and poorer health. Conclusion Nutrition education efforts should focus on improving food diversity, with particular targeting of lower educated, single, and older people.

The aim of the study was to compare the quality of life among stroke survivors and healthy controls and to evaluate the influence of age, sex, and social and demographic factors on the quality of life. Contingent and methods. The case group consisted of 508 inhabitants of Kaunas city who were 25–84 years of age and had experienced their first stroke. The control group consisted of age- and sex-stratified randomly selected 508 stroke-free inhabitants of Kaunas city. The quality of life was evaluated using the SF- 12 questionnaire. The study compared the quality of life between stroke survivors and controls in eight domains of quality of life and compared the evaluation of quality of life considering social and demographic features. Results. In the domain of physical and mental health, stroke survivors presented poorer evaluation of their quality of life compared to controls except for the evaluations of mental health in the age groups of 25–34 and 35–44 years. As compared to healthy controls, stroke survivors presented poorer evaluation of their quality of life in all domains except for pain. Only in the control group, females presented poorer evaluation of physical health, whereas no differences in the evaluation of mental health between sexes were found. The evaluation of physical health in both groups worsened with age. Both stroke survivors and controls presented better evaluation of their physical health if they were living not alone, were better educated, and were employed compared to those who were living alone, had poorer education level, and were unemployed. In addition, controls who were currently or previously engaged in mental work evaluated their physical health better. Conclusions. Stroke survivors presented poorer evaluations of their quality of life in both physical and mental health domains compared to controls. Only in the control group, females evaluated their physical health worse than males did. In both groups studied, poorer evaluation of physical health was associated with older age and lower social and demographic status. Relationship between mental health and subjects’ social and demographic status was not statistically significant in either of the studied groups.

Depresija yra viena dažniausių būklių, pasireiš-kiančių po insulto. Manoma, kad iki 50 proc. visų persirgusių galvos smegenų insultu asmenų per pirmuosius metus po insulto patiria depresiją. Bendrieji poinsultinės depresijos aspektaiJau seniai yra žinoma, kad galvos smegenų insultas (GSI) ir depresija yra susiję. Depresija ne tik dažna GSI pasekmė, bet taip pat ir insultas yra aiškus depresijos rizikos veiksnys (1). Poinsultinė depresija gali pasireikšti nepriklausomai nuo amžiaus, lyties, išsila-vinimo, socialinės padėties ar GSI sunkumo. Depresija gali pasireikšti iš karto po GSI arba praėjus kelioms savaitėms ar mėnesiams. Dauguma žmonių, persirgusių GSI, dėl poinsultinės depresijos reguliariai netiriami, ir tik nedaugeliui ši liga anksti diagnozuojama bei veiksmingai gydoma. Paprastai depresija pasireiškia pasibaigus pradiniam sveikimo laikotarpiui, kai GSI patyrę pacientai suvokia, kaip jų ilgalaikis neįgalumas paveiks kasdienį gyvenimą: gali tekti susitaikyti su daugelio vilčių ir ateities planų žlugimu, prisitaikyti prie pakitusio vaidmens šeimoje, galbūt prarasti karjerą (2). Poinsultine depresija sergančių pacientų funkcinė būklė yra blogesnė, kognityviniai sutrikimai sunkesni, o mirtingumas didesnis negu persirgusių insultu, bet depresija nesergančių pacientų (3). Depresija neigiamai veikia ir GSI patyrusių pacientų motyvaciją (2). Būtų logiška tikėtis, kad poinsultinė depresija neigiamai veikia funkcijų atsigavimą, tačiau jos įtaka reabilitacijos rezultatams lieka diskutuotina. Kai kurie autoriai (4) nustatė, kad poinsultinė depresija neigiamai veikia kasdienės veiklos funkcijų atsigavimą, tačiau kiti autoriai tokios sąsajos nepatvirtino (2, 5).Poinsultinės depresijos paplitimas svyruoja nuo 30 iki 50 proc. (6). R. G. Robinson duomenimis, per pirmuosius tris mėnesius po insulto sunkios depresijos paplitimas siekia 27 proc., lengvos -20 proc. (6). A. House nustatė, kad 11 proc. pacientų sunki depresija pasireiškė praėjus mėnesiui, 5 proc. -praėjus metams po GSI. Sunkios depresijos paplitimas, praėjus 12-18 mėnesių po GSI, yra dukart didesnis negu bendrojoje populiacijoje (7,8). M. Åström ir kt. nustatė, kad sunkios poinsultinės depresijos paplitimas buvo 25 proc. Ūminiu laikotarpiu ir maždaug toks pat -po trijų mėnesių (31 proc.). Praėjus 12 mėnesių nuo GSI pradžios, jis sumažėjo iki 16 proc., po dvejų metų buvo 19 proc., o praėjus trejiems metams padidėjo iki 29 proc. (pav.). Po trijų mėnesių nuo GSI svarbiausiu prognoziniu poinsultinės depresijos veiksniu tapo ribotas dalyvavimas kasdienėje veikloje. Nuo 12-ojo mėnesio depresija labiausiai sustiprėjo tiems pacientams, kurie turėjo mažai socialinių kontaktų už savo šeimos ribų, o praėjus trejiems metams prie