[Factors Associated with Functional Deterioration in Stroke Patients 3 Years after Onset: A KOSCO Study]

This study aimed to identify the factors predicting functional decline 4 years after stroke based on patient characteristics 3 years after stroke. We analyzed data from the Korean Stroke Cohort for Functioning and Rehabilitation study. Functional decline was defined as an increase in the modified Rankin scale (mRS) 4 years after stroke compared to that at 3 years after stroke. Participants were divided into two groups based on their mRS 3 years after stroke: independent (mRS 0-1) and dependent (mRS 2-4) activities of daily living groups. Of the 4,023 participants, 3,028 were in the independent group and 995 in the dependent group. Functional decline was observed in 12.9% and 12.1% of the independent and dependent groups, respectively, 4 years after stroke. In the independent group, age, degree of comorbidity, and mobility function 3 years after stroke were identified as predictors of functional decline. In the dependent group, age and cognitive function 3 years after stroke were predictive factors. These findings can contribute to the development of tailored rehabilitation strategies to prevent functional decline in patients with chronic stroke.