The influence of age on stroke outcome. The Copenhagen Stroke Study.

Abstract

This study was undertaken to elucidate whether and how age influences stroke outcome. This prospective and community-based study comprised 515 consecutive acute stroke patients. Computed tomographic scan was performed in 79% of patients. Activities of daily living (ADL) and neurological status were assessed weekly during hospital stay using the Barthel Index (BI) and the Scandinavian Stroke Scale (SSS), respectively. Information regarding social condition and comorbidity before stroke was also registered. A multiple regression model was used to analyze the independent influence of age on stroke outcome. Age was not related to the type of stroke lesion or infarct size. However, age independently influenced initial BI (-4 points per 10 years, P < .01), initial SSS (-2 points per 10 years, P = .01), and discharge BI (-3 points per 10 years, P < .01). No independent influence of age was found regarding mortality within 3 months, discharge SSS, length of hospital stay, and discharge placement. ADL improvement was influenced independently by age (-3 points per 10 years, P < .01), whereas age had no influence on neurological improvement or on speed of recovery. Age independently influences stroke outcome selectively in ADL-related aspects (BI) but not in neurological aspects (SSS), suggesting a poorer compensatory ability in elderly stroke patients. Therefore, rehabilitation of elderly stroke patients should be focused more on ADL and compensation rather than on the recovery of neurological status, and age itself should not be a selection criterion for rehabilitation.