{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:23:03Z","timestamp":1791872583261,"version":"4.3.4"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose:<\/jats:title>\n            <jats:p>In the chronic phase 2 to 5 years poststroke, limitations in activities of daily living (ADL) and instrumental ADL (IADL) initially plateau before steady increasing. However, the impact of age and differences in initial levels of disability on the evolution of these limitations remains unclear. As such, this study aims to evaluate differences in long-term evolution of ADL\/IADL limitations between stroke survivors and stroke-free population, and how limitations differ by initial level of disability for stroke survivors.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Thirty-three thousand six hundred sixty participants (5610 first-ever stroke cases with no recurrence during follow-up and 28\u2009050 stroke-free controls) aged \u226550 from the Health and Retirement Study, Survey of Health, Ageing and Retirement in Europe, and English Longitudinal Study of Ageing were assessed for number of ADL\/IADL limitations during the poststroke chronic phase (for cases) and over follow-up years 1996 to 2018 (for controls). Three thousand seven hundred eighteen stroke cases were additionally categorized by disability level using the modified Rankin Scale score of 1 to 2 years poststroke. Evolution of ADL\/IADL limitations was assessed in stroke cases and controls and by modified Rankin Scale score (0\u20131, 2\u20133, 4\u20135) using linear mixed models. Models were stratified by age group (50\u201374 and \u226575 years) and adjusted for baseline characteristics, health behaviors, BMI, and comorbidities.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Findings showed relative stability of ADL\/IADL limitations during 3 to 6 years poststroke followed by an increase for both populations, which was faster for younger stroke cases, suggesting a differential age-effect (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Disability level at 1 to 2 years poststroke influenced the evolution of limitations over time, especially for severe disability (modified Rankin Scale score, 4\u20135) associated with a reduction in limitations at 5 to 6 years poststroke.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Our findings showed that during the poststroke chronic phase functional limitations first plateau and then increase and the evolution differs by disability severity. These results highlight the importance of adaptive long-term health and social care measures for stroke survivors.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.121.034534","type":"journal-article","created":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T09:00:29Z","timestamp":1630573229000},"page":"228-237","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":48,"title":["Long-Term Evolution of Functional Limitations in Stroke Survivors Compared With Stroke-Free Controls: Findings From 15 Years of Follow-Up Across 3 International Surveys of Aging"],"prefix":"10.1161","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7838-8752","authenticated-orcid":true,"given":"Andres","family":"Gil-Salcedo","sequence":"first","affiliation":[{"name":"Universit\u00e9 de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, France (A.G.-S., A.D., A.F., L.J., S.S., A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aline","family":"Dugravot","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, France (A.G.-S., A.D., A.F., L.J., S.S., A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2646-9408","authenticated-orcid":true,"given":"Aurore","family":"Fayosse","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, France (A.G.-S., A.D., A.F., L.J., S.S., A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1071-1239","authenticated-orcid":true,"given":"Louis","family":"Jacob","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, France (A.G.-S., A.D., A.F., L.J., S.S., A.S.)."},{"name":"Research and Development Unit, Parc Sanitari Sant Joan de D\u00e9u, CIBERSAM, Spain (L.J.)."},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Salud Mental (CIBERSAM), Madrid, Spain (L.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2453-6283","authenticated-orcid":true,"given":"Mikaela","family":"Bloomberg","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, University College London, United Kingdom (M.B., S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9verine","family":"Sabia","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, France (A.G.-S., A.D., A.F., L.J., S.S., A.S.)."},{"name":"Department of Epidemiology and Public Health, University College London, United Kingdom (M.B., 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