Long-term performance of instrumental activities of daily living (IADL) in young and middle-aged stroke survivors: Results from SAHLSIS outcome

Abstract

Background: Although stroke prevalence is increasing and large proportions of stroke survivors are expected to live many years after stroke onset, research on the long-term consequences of stroke for instrumental activities of daily living (IADL) is limited.

Aim: To explore performance of IADL seven years post-stroke onset and identify predictors of long-term IADL performance based on commonly employed acute measures and demographic characteristics in young and middle-aged stroke survivors.

Methods: Data on stroke survivors were collected from SAHLSIS. IADL performance was assessed at 7 years using the Frenchay Activities Index (FAI). Demographic data and baseline measures were assessed as predictors of FAI outcome, using logistic regression.

Results: 237 stroke survivors with a median age of 63 at follow-up were included. Participants had predominantly suffered a mild stroke and >90% lived at home with no community services. Mean FAI was 25.7(score range 0-45), indicating reduced levels of participation in IADL. Frequency of performance of IADL was lowest for work/leisure activities. Gender, cohabitation status, initial stroke severity and baseline score on mRS were independently associated with IADL outcome.

Conclusions: Reduced levels of participation in IADL persist many years after stroke onset and indicate a need to adapt a long-term perspective on stroke rehabilitation.

Keywords:

• ADL
• cerebrovascular disorders
• cohort study

Acknowledgements

The authors wish to thank all participants in the Sahlgrenska Academy Study on Ischaemic Stroke. We also thank Ingrid Eriksson, Sven-Öjvind Swahn, and Jenny Ödquist Pettersson for their excellent work in the SAHLSIS group; Nils-Gunnar Pehrsson and Mattias Molin from Statistiska Konsultgruppen for their expertise in medical statistics, and Gunnel Carlsson for sharing her knowledge of stroke outcome and its relation to everyday occupations.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

 This project was supported by grants from Stroke Centre West, The Research and Development Council of the County of Södra Älvsborg and of Södra Älvsborgs Sjukhus, STROKE-Riksförbundet, Stiftelsen Handlanden Hjalmar Svenssons Research Fund, The Swedish Research Council, The Swedish Heart-Lung Foundation and Region Västra Götaland and University of Gothenburg under the ALF agreement.