Abstract
In France, the prevalence of stroke and the level of disability of stroke survivors are little known. The aim of this study was to evaluate functional limitations in adults at home and in institutions, with and without self-reported stroke. A survey named “the Disability Health survey” was carried out in people's homes (DHH) and in institutions (DHI). Medical history and functional level (activities-of-daily-living, ADL and instrumented-activities-of-daily-living IADL) were collected through interviews. The modified Rankin score (mRS) and the level of dependence and disability were compared between participants with and without stroke. 33896 subjects responded. The overall prevalence of stroke was 1.6% (CI95% [1.4%–1.7%]). The mRS was over 2 for 34.4% of participants with stroke (28.7% of participants at home and 87.8% of participants in institutions) versus respectively 3.9%, 3.1% and 71.6% without stroke. Difficulty washing was the most frequently reported ADL for those with stroke (30.6% versus 3% for those without stroke). Difficulty with ADL and IADL increased with age but the relative risk was higher below the age of 60 (17 to 25) than over 85 years (1.5 to 2.2), depending on the ADL. In the overall population, 22.6% of those confined to bed or chair reported a history of stroke. These results thus demonstrate a high national prevalence of stroke. Older people are highly dependent, irrespective of stroke history and the relative risk of dependence in young subjects with a history of stroke is high compared with those without.
Highlights
Stroke is a common and serious pathology
The questions regarding limitations of motor function and basic activities of daily living (ADL) included in all the surveys were used to compare the functional level of the subjects who reported a history of stroke with that of subjects who did not report a history of stroke
The results of the DHH and DHI surveys showed a prevalence of self-reported stroke of 1.6% (CI95% [1.4%–1.7%]) in the global French adult population and of 3.2% in those aged 50 or more
Summary
Stroke is a common and serious pathology. It is the third cause of mortality in the world [1] and one of the major causes of disability. In France, the Dijon registry reported an incidence of first ever stroke of 113 per 100 000 inhabitants [2]. The level of mortality following stroke in France is among the ten lowest in the world (51.1 per 100 000 inhabitants in 2009) [5, 6]. Most studies on the prevalence of stroke are regional studies and tend to be focused on the older population [7,8,9]. The prevalence of stroke is 62 million and is expected to reach 77 million in 2030 [7]
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