Combined Association of Multiple Chronic Diseases and Social Isolation With Functional Disability in Elderly Stroke Patients: A Multicentre Cross-sectional Study in China
Abstract BackgroundMultiple chronic diseases (MCDs) and social isolation are independent risk factors related with stroke and disability, but it is unknown whether the combination of these two conditions resulted from ageing related to functional disability in stroke patients. The purpose of this study was to probe the relationship between combination of MCDs, social isolation and functional disability in elderly stroke patients.MethodsA multicentre and cross-sectional study was conducted in the Departments of Rehabilitation Medicine of 103 hospitals located in 23 cities across China. Stroke patients aged over 60 years were selected as participants. Demographic characteristics, lifestyles and clinical information were investigated by questionnaire and medical records. Multi-nominal logistic regression model was used to explore the association of MCDs, social isolation and their combination with functional disability assessed by Barthel Index Scale.ResultsA total of 4281 elderly stroke patients were included in the final analysis. The proportion of social isolation and MCDs (>1) increased by the severity of functional disability. Social isolation was associated with increased risks for mild (33%), moderate (175%), and severe (833%) functional disability significantly in their comparisons with those without social isolation and MCDs. The intragroup odds ratio (OR) of MCDs increased by its number and the intergroup of OR increased by the severity of functional disability significantly. Social isolation and ≥3 MCDs associated the highest risk for severe (OR= 38.24, 95%CI: 14.76-99.07) and moderate (OR = 9.74, 95%CI: 3.62-26.22) functional disability, but not significant for mild group.ConclusionsMCDs, social isolation, and their combination were associated with functional disability in Chinese elderly stroke patients. Future secondary prevention and rehabilitation for functional disability in this population should underscore both social activity and the combined treatments of MCDs.Clinical Trial Registration NOChiCTR2000034067.