Racial differences in disability after stroke: results from a nationwide study

Area of Science:

• Gerontology and Rehabilitation Medicine
• Public Health and Health Disparities Research

Background:

• Stroke significantly impacts disability and participation in older adults.
• Racial disparities in health outcomes, including post-stroke disability, are a persistent concern in the United States.

Purpose of the Study:

• To investigate and characterize racial differences in activity limitations and participation restrictions among older stroke survivors.
• To identify factors contributing to these racial disparities in disability post-stroke.

Main Methods:

• Cross-sectional study utilizing data from 806 self-reported stroke survivors from the 2011 National Health and Aging Trends Study.
• Activity limitations (requiring assistance) and participation restrictions (reduced social activities) were primary and secondary outcomes, respectively.
• Logistic regression analyses were performed to assess racial differences before and after adjusting for sociodemographics, comorbidities, and physical/cognitive capacity.

Main Results:

• Non-Hispanic black stroke survivors exhibited significantly lower physical capacity compared to non-Hispanic white survivors.
• Black participants reported greater activity limitations across most domains, persisting after adjustments for sociodemographics and comorbidities.
• These activity limitation disparities were largely attenuated after accounting for differences in physical capacity.

Conclusions:

• Black individuals experience a higher prevalence of activity limitations after stroke, predominantly linked to reduced physical capacity.
• Addressing the underlying causes of racial disparities in physical capacity post-stroke is crucial for reducing activity limitations and health inequities.