Associations between diagnosis with stroke, comorbidities, and activity of daily living among older adults in the United States

Author:

Ruksakulpiwat Suebsarn1ORCID,Zhou Wendie2,Phianhasin Lalipat1,Benjasirisan Chitchanok1ORCID,Salehizadeh Saeideh3,Wang Limin4,Voss Joachim G.5

Affiliation:

1. Department of Medical Nursing, Faculty of Nursing Mahidol University Bangkok Thailand

2. School of Nursing Peking University Beijing China

3. University Hospitals Cleveland Medical Center Cleveland Ohio USA

4. School of Nursing Zhejiang Chinese Medical University Zhejiang China

5. Frances Payne Bolton School of Nursing Case Western Reserve University Cleveland Ohio USA

Abstract

AbstractBackgroundStroke is the leading cause of mortality. This study aimed to investigate the association between stroke, comorbidities, and activity of daily living (ADL) among older adults in the United States.MethodsParticipants were 1165 older adults aged 60 and older from two waves (2016 and 2018) of the Health and Retirement Study who had a stroke. Descriptive statistics were used to describe demographic information and comorbidities. Logistic regressions and multiple regression analyses were used to determine associations between stroke, comorbidities, and ADL.ResultsThe mean age was 75.32 ± 9.5 years, and 55.6% were female. An adjusted analysis shows that older stroke adults living with diabetes as comorbidity are significantly associated with difficulty in dressing, walking, bedding, and toileting. Moreover, depression was significantly associated with difficulty in dressing, walking, bathing, eating, and bedding. At the same time, heart conditions and hypertension as comorbidity were rarely associated with difficulty in ADL. After adjusting for age and sex, heart condition and depression are significantly associated with seeing a doctor for stroke (odds ratio [OR]: 0.66; 95% confidence interval [CI]: 0.49–0.91; p = 0.01) and stroke therapy (OR: 0.46; 95% CI: 0.25–0.84; p = 0.01). Finally, stroke problem (unstandardized β [B] = 0.58, p = 0.017) and stroke therapy (B = 1.42, p < 0.001) significantly predict a lower level of independence.ConclusionThis study could benefit healthcare professionals in developing further interventions to improve older stroke adults' lives, especially those with a high level of dependence.

Funder

National Institute on Aging

Publisher

Wiley

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