Abstract P257: Self-Perception of Mental and Physical Health Are Significant Predictors of Activities of Daily Living

Abstract

Background: Stroke is a leading cause of long-term disability and death worldwide. Stroke results in impaired physical, psychological, and social functions. This study examined the extent to which self-perception of physical and mental health, conditions manageable by behavioral intervention (MBI), and medical conditions contribute to activities of daily living (ADL) performance post-stroke among adults aged 65 and above. Methods: Data from the 2017 Medicare Health Outcomes Survey Cohort 19 were analyzed. The outcome variable was defined as, being able to independently perform basic ADL such as bathing, dressing, eating, getting in and out of the chair, walking, and using the toilet. Stepwise binary logistic regression was used to identify risk factors that predict overall ADL performance. Results: A total of 9,531 older adults with stroke were included in the study, 56.97% of whom were females. Overall, 58.6% had some difficulty or were unable to perform ADLs post-stroke. In the final model, self-perception of physical (OR=0.89, 95% CI=0.883, 0.896) and mental (OR=0.961, 95% CI=0.954, 0.968) health and older (74+) age (OR=1.7, 95% CI=1.452,1.895) were associated with difficulty in self-perception of ADL. A 12.2% increase in explained variance after adding medical conditions such as diabetes, hypertension, cancer, etc. to demographic factors; a 13.6% increment in explained variance after adding conditions MBI such as obesity, smoking, pain, etc.; and a 10.5% increment after adding self-perception of mental and physical health was obtained. The final model explained 39.4% of the total variance in the self-perception of ADL. Conclusion: Not only conditions manageable by behavior interventions, and medical conditions predict performance, but self-perceptions of mental and physical health have an impact on ADL. The significant association between self-perception and ADL found in this study signals the need for new avenues for interventions for persons with stroke with respect to their ability to perform self-care activities. These findings can inform future work that identifies and addresses psychosocial and behavioral risk factors that contribute to ADL.