Diabetes and obesity are associated with disability in community-dwelling stroke survivors: A cross-sectional study of 37,955 Behavioral Risk Factor Surveillance System respondents

ABSTRACT

Purpose

Stroke increases risk for disability. Obesity and diabetes also increase risk for disability in the general population, but their association with disability in stroke survivors is unknown. We examined disability risk associated with obesity and diabetes in stroke survivors across six disability types: hearing, vision, cognition, mobility, and basic and instrumental activities of daily living (ADLs).

Materials and Methods

Data from 37,955 community-dwelling US stroke survivors aged ≥18 years were analyzed from the 2017 and 2018 Behavioral Risk Factor Surveillance System. Linear regression was used to calculate prevalence of each disability type. Survivors were stratified by obesity versus normal weight and diabetes vs no diabetes, and logistic regression was used to calculate adjusted odds ratios (AOR) for each disability type, adjusted for demographic information.

Results

Prevalences of disability types ranged from 14.2% to 36.0%. Among survivors with obesity, odds were elevated for mobility (AOR: 1.68) and basic ADL (AOR: 1.55) disability. Among survivors with diabetes, odds were elevated for all disability types (AOR range: 1.15–1.71).

Conclusion

Stroke survivors with obesity or diabetes experience increased risk for disability compared to survivors without these chronic conditions. Interventions for managing disability, obesity, and diabetes concomitantly may be warranted and deserve further consideration.

KEYWORDS:

• Activities of daily living
• cognition
• disability
• hearing
• mobility
• stroke
• vision

Data availability

Behavioral Risk Factor Surveillance System (BRFSS) data are freely available from the Centers for Disease Control and Prevention and can be accessed online (https://www.cdc.gov/brfss/).