The association between socioeconomic status and disability after stroke: findings from the Adherence eValuation After Ischemic stroke Longitudinal (AVAIL) registry.
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BACKGROUND: Stroke is the leading cause of disability among adults in the United States. The association of patients' pre-event socioeconomic status (SES) with post-stroke disability is not well understood. We examined the association of three indicators of SES--educational attainment, working status, and perceived adequacy of household income--with disability 3-months following an acute ischemic stroke. METHODS: We conducted retrospective analyses of a prospective cohort of 1965 ischemic stroke patients who survived to 3 months in the Adherence eValuation After Ischemic stroke--Longitudinal (AVAIL) study. Multivariable logistic regression was used to examine the relationship of level of education, pre-stroke work status, and perceived adequacy of household income with disability (defined as a modified Rankin Scale of 3-5 indicating activities of daily living limitations or constant care required). RESULTS: Overall, 58% of AVAIL stroke patients had a high school or less education, 61% were not working, and 27% perceived their household income as inadequate prior to their stroke. Thirty five percent of patients were disabled at 3-months. After adjusting for demographic and clinical factors, stroke survivors who were unemployed or homemakers, disabled and not-working, retired, less educated, or reported to have inadequate income prior to their stroke had a significantly higher odds of post-stroke disability. CONCLUSIONS: In this cohort of stroke survivors, socioeconomic status was associated with disability following acute ischemic stroke. The results may have implications for public health and health service interventions targeting stroke survivors at risk of poor outcomes.
SubjectActivities of Daily Living
Published Version (Please cite this version)10.1186/1471-2458-14-281
Publication InfoBettger, Janet Prvu; Zhao, Xin; Bushnell, Cheryl Diane; Zimmer, L; Pan, Wenqin; Williams, LS; & Peterson, Eric David (2014). The association between socioeconomic status and disability after stroke: findings from the Adherence eValuation After Ischemic stroke Longitudinal (AVAIL) registry. BMC Public Health, 14. pp. 281. 10.1186/1471-2458-14-281. Retrieved from https://hdl.handle.net/10161/15013.
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Associate Professor of Orthopaedic Surgery
Dr. Bettger’s research is dedicated to establishing real world evidence aimed to improve health care quality and policies that reduce the burden of disease and disability. As a health services researcher and implementation scientist, her research extends from observational studies to randomized and pragmatic trials. She is currently principal investigator for the VERITAS implementation-effectiveness RCT of a physical therapist supported virtual care management strategy for exercise
Adjunct Assistant Professor in the Department of Neuology
1. Impact of hormone replacement therapy on ischemic stroke severity in women. Currently conducting an observational outcome study comparing women using or not using HRT at the time of stroke. Outcomes include stroke severity with the NIH Stroke Scale, and disability, handicap, and quality of life measurements at 3 months post-stroke. Patients will be followed for 2 years for recurrent thrombotic events. 2. Impact of concomitant medication use, such as cholesterol-lowering drugs, on
Fred Cobb, M.D. Distinguished Professor of Medicine
Dr Peterson is the Fred Cobb Distinguished Professor of Medicine in the Division of Cardiology, a DukeMed Scholar, and the Past Executive Director of the Duke Clinical Research Institute (DCRI), Durham, NC, USA. Dr Peterson is the Principal Investigator of the National Institute of Health, Lung and Blood Institute (NHLBI) Spironolactone Initiation Registry Randomized Interventional Trial in Heart Failure With Preserved Ejection Fraction (SPIRRIT) Trial He is also the Principal I
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