Changes in disability and wellbeing after stroke

Area of Science:

• Gerontology
• Neurology
• Public Health

Background:

• Wellbeing is crucial for a meaningful life, but its relationship with post-stroke disability is unclear.
• Prior research often overlooks pre-stroke wellbeing and focuses on cross-sectional data.
• Understanding how new disabilities impact wellbeing after stroke is essential for older adults.

Purpose of the Study:

• To examine the longitudinal relationship between changes in disability and wellbeing after stroke in older adults.
• To determine the influence of pre-stroke wellbeing and disability on post-stroke wellbeing.
• To assess the trajectory of wellbeing over time following a stroke.

Main Methods:

• Longitudinal analysis of community-dwelling adults aged 65+ from the National Health and Aging Trends Survey.
• Stroke survivors identified via self-report; disability defined as needing help with self-care or mobility activities.
• Multilevel linear regression used to analyze associations between changes in functional assistance needs and wellbeing outcomes (emotion, self-realization).

Main Results:

• Each additional activity requiring help post-stroke was linked to significantly lower wellbeing (β=-0.38, p < 0.01).
• Baseline disability did not predict post-stroke wellbeing (β=-0.08, p = 0.30).
• Pre-stroke wellbeing positively predicted post-stroke wellbeing (β=0.76, p < 0.01), but wellbeing declined annually post-stroke (β = -0.13, p < 0.01).

Conclusions:

• Increased need for assistance after stroke negatively impacts wellbeing, unlike pre-existing disability levels.
• While pre-stroke wellbeing is protective, wellbeing continues to decrease post-stroke.
• Findings suggest wellbeing following stroke may be a target for interventions to improve long-term outcomes.