Cognitive dysfunction predicts worse health-related quality of life for older stroke survivors: a nationwide population-based survey in Taiwan

ABSTRACT

Objectives: This study investigated the associations of cognitive status with specific/overall health-related quality of life (HRQoL) in older stroke survivors in Taiwan.

Method: A subsample of 592 older stroke survivors in a nationwide population-based survey of cognitive-dysfunction prevalencewas analyzed. HRQoL was assessed using the EuroQol five-dimension questionnaire (EQ-5D).

Results: Stroke survivors with dementia were 5.60 times more likely to have mobility problems, 12.20 times to have self-care problems, 16.61 times to have problems in usual activities, 4.31 times to have pain/discomfort, and 3.28 times to have anxiety/depression than stroke survivors with normal cognitive function. Stroke survivors with mild cognitive dysfunction (MCD) were 2.57 times more likely to have mobility problems, 3.17 times to have self-care problems, 3.31 times to have problems in usual activities, 2.11 times to have pain/discomfort, and 2.35 times to have anxiety/depression than those with normal cognitive function. Both dementia (b = −15.13, p < .001) and MCD (b = −6.24, p < .001) significantly contributed to lower EQ-5D VAS; both dementia (b = −.15, p < .001) and MCD (b = −.10, p < .001) significantly contributed to lower EQ-5D index.

Conclusion: Dementia and MCD strongly predicted worse overall and specific HRQoL dimensions, especially self-care and usual activities for older stroke survivors.

KEYWORDS:

• Stroke
• older persons
• mild cognitive dysfunction
• dementia
• HRQoL

Acknowledgments

The authors would like to express their gratitude to the Taiwan Alzheimer's Disease Association for its invaluable contributions to this study, in that we used a database which it conducted, and was supported in part, under commission of the Ministry of Health and Welfare of Taiwan (DOH100-TD-M113-100001). The views expressed throughout this study are exclusively those of the authors and do not represent the views or opinions of the Ministry of Health and Welfare, Taiwan.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by grants from the Chang Gung Medical Foundation [grant number BMRP297], [grant number CMRPD1E0162]; Ministry of Health and Welfare of Taiwan [grant number DOH100-TD-M113-100001].