Abstract 44: Quality of Life for Younger Patients Following Lacunar Stroke: A Secondary Analysis of SPS-3

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Adam H de Havenon ◽  
Ka-Ho Wong ◽  
Kirby Taylor ◽  
Michael Dela Cruz ◽  
Theodore Rock ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Patients ◽  
Secondary Analysis ◽  
Lacunar Stroke ◽  
Linear Regression Models ◽  
Stroke Patients ◽  
Younger Patients ◽  
Student’S T ◽  
One Year

Background: The long-term quality of life (QoL) effects of stroke on younger patients has not been adequately compared to older stroke patients. Methods: We included patients from the Secondary Prevention of Small Subcortical Strokes (SPS3) trial, who had a lacunar stroke within the last 6 months. We divided the cohort into younger patients aged <55 years versus older patients aged ≥55. The primary outcome was a 12 domain stroke specific QoL scale (ss-QoL), measured at one year from enrollment. The ss-QoL scores range from 0-5, with higher scores indicating better QoL. We fit linear regression models to the 12 domains and their mean, and adjusted for 90-day mRS, gender, white race, history of MI, diabetes, HTN, COPD, and level of education. After identifying domains of interest, we examined specific questions within domains to compare the mean score on individual questions using Student’s t-test. Results: We included 2,542 patients with a mean (SD) age of 62.8 (10.7) and 64% were male. Younger stroke patients comprised 26.5% (673/2,542) of the cohort and had a mean (SD) ss-QoL score of 4.18 (0.75) compared to 4.24 (0.69) of the older patients, a difference which was significant in the adjusted model (p=0.015). Younger stroke patients had significantly lower scores on the following individual ss-QoL domains compared to older stroke patients: language, thinking, personality, mood, family roles, and energy (Table 1). The three questions that younger stroke patients had the most difference with older patients were “in the past week I was discouraged about my future” (young vs old, 3.7 vs 4.0, p<0.001), “…had little confidence in myself” (4.0 vs 4.3, p<0.001), and “…was irritable” (3.7 vs 3.9, p<0.001). Conclusion: After lacunar stroke, compared to older patients, younger patients score worse on stroke specific quality of life at 1-1.5 years after stroke, particularly in domains related to mood. This under-appreciated impact of stroke in the young warrants additional research.

scholarly journals Fatigue Impact Scale Demonstrates Greater Fatigue in Younger Stroke Survivors

2012 ◽  
Vol 39 (5) ◽  
pp. 619-625 ◽  
Author(s):  
Natalie E. Parks ◽  
Gail A. Eskes ◽  
Gordon J. Gubitz ◽  
Yvette Reidy ◽  
Christine Christian ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ischemic Stroke ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Younger Patients ◽  
Post Stroke ◽  
Impact Scale ◽  
Fatigue Impact Scale ◽  
One Year

Background:Fatigue affects 33-77% of stroke survivors. There is no consensus concerning risk factors for fatigue post-stroke, perhaps reflecting the multifaceted nature of fatigue. We characterized post-stroke fatigue using the Fatigue Impact Scale (FIS), a validated questionnaire capturing physical, cognitive, and psychosocial aspects of fatigue.Methods:The Stroke Outcomes Study (SOS) prospectively enrolled ischemic stroke patients from 2001-2002. Measures collected included basic demographics, pre-morbid function (Oxford Handicap Scale, OHS), stroke severity (Stroke Severity Scale, SSS), stroke subtype (Oxfordshire Community Stroke Project Classification, OCSP), and discharge function (OHS; Barthel Index, BI). An interview was performed at 12 months evaluating function (BI; Modified Rankin Score, mRS), quality of life (Reintegration into Normal living Scale, RNL), depression (Geriatric Depression Scale, GDS), and fatigue (FIS).Results:We enrolled 522 ischemic stroke patients and 228 (57.6%) survivors completed one-year follow-up. In total, 36.8% endorsed fatigue (59.5% rated one of worst post-stroke symptoms). Linear regression demonstrated younger age was associated with increased fatigue frequency (β=-0.20;p=0.01), duration (β=-0.22;p<0.01), and disability (β=-0.24;p<0.01). Younger patients were more likely to describe fatigue as one of the worst symptoms post-stroke (β=-0.24;p=0.001). Younger patients experienced greater impact on cognitive (β=-0.27;p<0.05) and psychosocial (β=-0.27;p<0.05) function due to fatigue. Fatigue was correlated with depressive symptoms and diminished quality of life. Fatigue occurred without depression as 49.0% of respondents with fatigue as one of their worst symptoms did not have an elevated GDS.Conclusions:Age was the only consistent predictor of fatigue severity at one year. Younger participants experienced increased cognitive and psychosocial fatigue.

Abstract 17469: Comparing the Effect of CRT Implantation on Quality of Life in Older Patients Compared With Younger Patients: Systematic Review and Meta-Analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Praveen Ponnamreddy ◽  
Saeed Juggan ◽  
Lauren Gilstrap
Keyword(s):  
Quality Of Life ◽  
Older Patients ◽  
Meta Analysis ◽  
Nyha Class ◽  
Age Group ◽  
Walk Test ◽  
Younger Patients ◽  
Six Minute Walk Test ◽  
Minute Walk

Background: CRT had been accepted as standard of care for patients with HFrEF who qualify for the therapy. The pivotal CRT trials enrolled patients significantly younger than the typical HFrEF patients seen in the community. Benefits of CRT in older HFrEF patients is largely unknown. We sought to evaluate the change in quality of life in older patients undergoing CRT in comparison to younger patients. Hypothesis: CRT implantation is associated with comparable improvements in quality of life in younger patients (age <70) and older patients (age 70 and above). Methods: PubMed, The Cochrane Library, Scopus, and Web of Science were queried for comparative effectiveness studies of CRT in older HFrEF patients. We gathered data for Quality of life measurements including improvement in NYHA class, MLHFQ, Six minute walk test. MLHFQ, Six minute walk test data was analyzed qualitatively as data was insufficient to impute Standard deviation for mean change. Changes in NYHA class was analyzed quantitatively. Random effects meta-analysis of improvement in NYHA class and relative risk (RR) is reported along with estimates of heterogeneity Results: Seven studies [n=2494 for younger group and n=1035 for older group] were included in changes in NYHA class meta-analysis. Older age group patients had similar improvement in NYHA class compared to younger age group patients. Relative risk 0.99 with 95%CI 0.93-1.06 (figure). Five studies reported Baseline and follow up MLHFQ scores for both the groups. All the five studies reported improvements in MLHFQ in both the groups. Three studies reported change in six minute walk test in meters before and after CRT implantation. All the studies reported improvement in six minute walk test both in younger and older group. Conclusions: People older than 70 years of age with heart failure with reduced ejection fraction who qualify for CRT derive similar benefits with improvement in quality of life compared to patients aged less than 70 years of age.

scholarly journals Older Patients Are Less Affected by Radiochemotherapeutic Treatment than Younger

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Max J. Weiling ◽  
Wencke Losensky ◽  
Katharina Wächter ◽  
Teresa Schilling ◽  
Fabian Frank ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Cancer Patients ◽  
Older Patients ◽  
Normative Data ◽  
Age Groups ◽  
German Population ◽  
Younger Patients ◽  
Significant Difference

Purpose. The general assumption is that cancer therapy impairs the quality of life in elderly patients more than in younger ones. We were interested in the effects of radiochemotherapeutic treatment on the quality of life of elderly patients compared to younger patients and compared to normative data of a general German population. Methods and Materials. A total of 465 patients completed the EORTC QLQ-C30 questionnaire. Repetitive completion of the questionnaire over time led to 1407 datasets. Our patient cohort contained 197 (42.4%) patients with colorectal cancer followed by 109 (23.4%) patients with head and neck cancer, 43 (9.2%) patients with lung cancer, and 116 (25%) with other types of cancer. Patients were categorized into five age groups, the respective cut-offs being 40, 50, 60, and 70 years. Normative data were drawn from a population study of a general German population. Results. Functional scores and symptom scores were approximately stable between the different age groups. Our data does not suggest a significant difference between the investigated age groups. Advancing age evened out the differences between the normative data of the general German population and the cancer patients in 11 of 15 scores. Conclusions. The general belief about younger patients having fewer physical and psychological problems related to radiochemotherapy needs to be reconsidered. Overall resilience of older patients is apparently underestimated.

Comprehensive Assessment of the Elderly Cancer Patient: The Feasibility of Self-Report Methodology

2002 ◽  
Vol 20 (3) ◽  
pp. 770-775 ◽  
Author(s):  
Sally S. Ingram ◽  
Pearl H. Seo ◽  
Robert E. Martell ◽  
Elizabeth C. Clipp ◽  
Martha E. Doyle ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Cancer Patients ◽  
Daily Living ◽  
Older Patients ◽  
Age Groups ◽  
Well Being ◽  
Self Report ◽  
Younger Patients

PURPOSE: Comprehensive geriatric assessment (CGA) has aided the medical community greatly in understanding the quality-of-life issues and functional needs of older patients. With its professional team assessment approach, however, CGA may be time consuming and costly. The goal of the present study was to assess the ability of cancer patients to complete a self-administered CGA and then to characterize cancer patients across multiple domains and age groups. PATIENTS AND METHODS: Two hundred sixty-six male outpatient oncology patients at the Durham Veterans Affairs Medical Center were asked to fill out a survey assessing 10 domains (demographics, comorbid conditions, activities of daily living, functional status, pain, financial well being, social support, emotional state, spiritual well-being, and quality of life). RESULTS: Seventy-six percent of the patients who received their surveys and kept their appointments returned the assessment tool. Older oncology patients had significantly less education (P < .0001), income (P = .05), frequent exercise (P = .01), and chance of being disease free (P = .003) than younger patients. Other findings in older patients were a higher rate of marriage (P = .02), more difficulty in taking medications (P = .05), and less cigarette (P = .03) and alcohol (P = .03) use. Members of all age cohorts reported a sense of social support, with younger patients deriving this more from family and friends than older patients, and older patients deriving social support more from membership in religious communities than younger patients. No differences were found across age groups for number and impact of comorbid illnesses, number of medications, basic and instrumental activities of daily living, pain, overall health rating, financial adequacy, anxiety, depression, and quality of life. CONCLUSION: CGA can be conducted in an outpatient cancer community using a self-report format. Despite the fact that this population varied demographically across age groups and is limited to veterans, this study demonstrated remarkable similarities between younger and older cancer patients in terms of functional status, health states, and quality of life.

Personality Related to Quality-of-Life Improvement After Deep Brain Stimulation in Parkinson’s Disease (PSYCHO-STIM II)

2021 ◽  
pp. 1-13
Author(s):  
Mathilde Boussac ◽  
Christophe Arbus ◽  
Helene Klinger ◽  
Alexandre Eusebio ◽  
Elodie Hainque ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Linear Regression Models ◽  
Personality Dimensions ◽  
One Year ◽  
Deep Brain

Background: Deep brain stimulation of the sub-thalamic nucleus (DBS-STN) reduces symptoms in Parkinson’s disease (PD) patients with motor fluctuations. However, some patients may not feel ameliorated afterwards, despite an objective motor improvement. It is thus important to find new predictors of patients’ quality of life (QoL) amelioration after DBS-STN. We hypothesized that personality dimensions might affect QoL after DBS-STN. Objective: To evaluate associations between personality dimensions and QoL improvement one year after DBS-STN. Methods: DBS-STN-PD patients (n = 303) having answered the “Temperament and Character Inventory” (TCI) before surgery and the PDQ-39 before and one year after surgery were included, from the cohort study PREDI-STIM. Linear regression models were used to evaluate associations between TCI dimensions and change in PDQ-39 scores after DBS-STN. Results: Novelty Seeking and Cooperativeness scores before surgery were positively associated with PDQ-39 scores improvement after DBS-STN (FDR-adjusted p <  0.01). Moreover, paradoxically unimproved patients with deterioration of their PDQ-39 scores after DBS-STN despite improvement of their MDS-UPDRS-IV scores had lower Cooperativeness scores, while paradoxically improved patients with amelioration of their PDQ-39 scores despite deterioration of their MDS-UPDRS-IV scores had higher Reward Dependence scores. Conclusion: Some presurgical personality dimensions were significantly associated with QoL amelioration and discrepancy between motor state and QoL changes after DBS-STN in PD. Educational programs before DBS-STN should take in account patient personality dimensions to better deal with their expectations.

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