Heterogeneity in symptom burden and supportive care needs among older adults with ischemic stroke: a cross-sectional...

Older adults with ischemic stroke often experience multiple coexisting symptoms during recovery, which may lead to substantial supportive care needs. However, symptom burden may vary across individuals, and its heterogeneity and relationship with supportive care needs remain unclear. This study aimed to identify latent profiles of symptom burden among older adults with ischemic stroke and to examine differences in supportive care needs across these profiles.

A cross-sectional study was conducted among 388 older adults with ischemic stroke recruited from the neurology departments of three tertiary hospitals in Hengyang, Hunan Province, China, between November 2025 and March 2026. Symptom burden was assessed using the Symptom Burden Scale for Stroke Survivors, and supportive care needs were measured using the Stroke Supportive Care Needs Scale. Latent profile analysis was used to identify symptom-burden subgroups. The Bolck-Croon-Hagenaars method was applied to compare supportive care needs across profiles, and multinomial logistic regression was performed to examine factors associated with profile membership.

Three latent profiles of symptom burden were identified: low symptom burden (31.7%), moderate symptom burden (37.9%), and high symptom burden-physical dysfunction (30.4%). Supportive care needs differed significantly across the three profiles and generally increased from the low symptom burden group to the high symptom burden-physical dysfunction group. Patients in the high symptom burden-physical dysfunction group had greater needs in daily life, symptom management and care, rehabilitation nursing, and psychological support. Older age was associated with a higher likelihood of belonging to the more symptomatic profiles. In contrast, female sex and lower monthly income were associated with a higher likelihood of belonging to the high symptom burden-physical dysfunction group.

Older adults with ischemic stroke in the convalescent phase exhibited heterogeneous symptom burden that could be classified into three distinct latent profiles. These profiles were cross-sectionally associated with different patterns of supportive care needs. These findings provide preliminary profile-based evidence for understanding symptom burden heterogeneity and may help inform the prioritization of supportive care needs among older stroke survivors.