Young individuals with stroke in rehabilitation: a cohort study

Abstract

Stroke in younger populations is a public health crisis and the prevalence is rising. Little is known about the progress of younger individuals with stroke in rehabilitation. Characterization of the course and speed of recovery is needed so that rehabilitation professionals can set goals and make decisions. This was a cohort study with data extracted from electronic medical records. Participants were 408 individuals diagnosed with stroke who participated in inpatient rehabilitation in an urban, academic medical center in the USA. The main predictor was age which was categorized as (18–44, 45–64, 65–74 and 75+). Outcomes included baseline-adjusted discharge functional independence measure (FIM) scores and FIM efficiency. In linear regression models for FIM scores, the reference category was the youngest age group. The oldest group was discharged with significantly lower FIM total (B = −8.84), mobility (B = −4.13), self-care (B = −4.07) and cognitive (B = −1.57) scores than the youngest group after controlling for covariates. The 45–64 group also finished with significantly lower FIM total (B = −6.17), mobility (B = −2.61) and self-care (B = −3.01) scores than youngest group. FIM efficiencies were similar for all ages in each of the FIM scales. Younger individuals with stroke make slightly greater functional gains compared to older individuals with stroke, but other factors, such as admission scores, are more important and the rates of recovery may be similar.

A Contemporary Review of Epidemiology, Risk Factors, Etiology, and Outcomes of Premature Stroke

“…In general, younger patients exhibit better functional recovery and outcomes than older groups [105], with higher rates of younger patients achieving mRS scores of 0-1 or 0-2 at follow-up [11,106]. This may partly be due to an increase likelihood of receiving rehabilitative care [105]. Additionally, despite early benefits, a prospective study demonstrated that 20-year mortality rates among premature stroke patients are significantly higher than the general populace when matched for age, sex, and calendar-year [104].…”

“…In general, younger patients exhibit better functional recovery and outcomes than older groups [105], with higher rates of younger patients achieving mRS scores of 0-1 or 0-2 at follow-up [11,106]. This may partly be due to an increase likelihood of receiving rehabilitative care [105].…”

Effectiveness of rehabilitation for young patients with extensive right hemisphere cerebral infarction: A report of two cases

“…Patients with stroke aged 18-44 have significantly higher FIM scores than older patients. 6 Furthermore, return to work 12 months after stroke is associated with young age, acute stroke severity, and 3-month disability. 7 Case 2 required more than 12 months to return to work owing to the severe disability but was able to find new employment.…”

Stroke in the young

“…Younger stroke survivors are often said to have 'better' stroke recovery than their older counterparts. A recent study from Taiwan demonstrated that while younger participants indeed do tend to have better discharge functional independence measure scores, most young patients have at least some disabilities after stroke [39]. A 2020 feasibility trial of early vocational training out of the UK noted significant changes in vocational status after stroke for both intervention and control patients.…”