Abstract

Introduction: Stroke-related disability is common. Obesity and diabetes are associated with disability in the general population, but the elevated risk of disability in stroke survivors who also experience these conditions has not been reported. The purpose of this study was to examine prevalence of 6 disability types among stroke survivors stratified by obesity and diabetes statuses. Methods: Data from 37,955 non-institutionalized stroke survivors aged >18 years from the 2017 and 2018 Behavioral Risk Factor Surveillance System (BRFSS), a U.S.-based annual telephone survey, were analyzed. Self-reported disability types included deaf or difficulty hearing (deaf); blind or difficulty seeing (blind); difficulty concentrating, remembering, or making decisions (cognition); difficulty walking or climbing stairs (mobility), difficulty dressing or bathing (dressing); and difficulty doing errands alone (alone). Prevalence of disability types were computed using linear regression, and odds ratios (adjusted for demographic characteristics) among survivors with obesity (vs. normal weight) and diabetes (vs. no diabetes) were computed using logistic regression. Results: Prevalence of obesity and diabetes were 35.7% (95% CI: 29.5%-41.8%) and 24.8% (95% CI: 21.3%-28.3%), respectively. Prevalence was highest for mobility (36.0%), cognition (33.7%) and alone (28.3%) disability types. Compared to survivors with normal weight, survivors with obesity had elevated AORs for mobility (1.68) and dressing (1.55) disability; and compared to survivors without diabetes, survivors with diabetes had elevated AORs for all disability types (range: 1.17-1.71) (see Table). Conclusion: Obesity and diabetes increase risk for self-reported disability above the risk associated with stroke alone. Tailored interventions for stroke survivors with these conditions may be needed for decreasing disability and improving quality of life, and should be developed and explored.

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