Abstract
Longstanding disparities have been reported in stroke-related outcomes with blacks experiencing more post-stroke disabilities. Little is known about long-term disability outcomes among older stroke survivors. This study was a retrospective analysis of data from the 2015 National Health Interview Survey (NHIS). A group of 655 stroke survivors (541 white and 114 black) age 65 and older were asked to rate their ability to complete 10 functional tasks without special equipment. Univariate comparisons were completed using t-tests and chi-square statistics for racial comparisons of disability reports. Multinomial logistic regression was used to determine odds of reporting disability after controlling for relevant covariates. The mean age of the sample was 76.6 years. After controlling for relevant covariates, white stroke survivors were less likely to report the following tasks being “very difficult/can’t do at all” without using special equipment compared to blacks: reach overhead (OR = 0.39, 95% CI 0.23–0.65; p = 0.000) and grasp small objects (OR = 0.42, 95% CI 0.25–0.73; p = 0.002). Both black and white older stroke survivors experience significant post-stroke disability across a range of functional tasks. Slightly greater long term post-stroke disability appears to exist among older blacks.
Highlights
The worldwide burden of stroke is substantial as approximately 15 million individuals experience a stroke annually [1]
Asians had lower 30 day and 1 year mortality compared to all other groups after risk adjustment for stroke severity and other prognostic variables
Some have suggested that measurement approaches, timing of measurement during the recovery process, and other unmeasured contributors to outcomes are key contributors to the observed racial disparities [14]
Summary
The worldwide burden of stroke is substantial as approximately 15 million individuals experience a stroke annually [1]. A significant racial disparity in stroke exists as Non-Hispanic Blacks (Blacks) are at twice the risk of having a stroke for the first time compared to Non-Hispanic Whites (Whites) [2,3,4]. Greater stroke risk persists in the US among Blacks despite an overall decrease in ischemic stroke incidence among Whites in the US [5]. A secondary concern in the study of stroke-related racial disparities is that Blacks are more likely to experience strokes that culminate in greater stroke-related limitations [6]. Studies related to racial differences following the completion of rehabilitation have been mixed with some studies reporting worse outcomes among Blacks and others reporting no significant differences [6,7,8,9]
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