A zoomed picture shows two surgeons performing an operation in a Berlin hospital August 15, 2003. REUTERS/Fabrizio Bensch
NEW YORK (Reuters Health) - Older people may be at particularly high risk for stroke after being hospitalized for something else, a new 12-year study in Medicare patients shows.
While most of the other risk factors for stroke that Dr. Fredric D. Wolinsky of the University of Iowa in Iowa City and his colleagues identified in their study were not new, they did find that individuals living in multi-story residences were 40 percent more likely to have a stroke than those residing in a single-story house. This could reflect more congested, stressful living conditions, they suggest.
The investigators looked at a broad range of possible stroke risk factors in a representative group of 5,511 men and women 70 and older, all on Medicare, who were enrolled in a study in 1993-1994.
Based on the participants’ records through 2005, Wolinsky and his team found that between 6.8 percent and 9.9 percent of them had strokes, depending on how rigorously stroke was defined.
Regardless, risk factors for stroke included being 80 to 84 years old; never having been married; living in a multi-story building; having a history of diabetes, hypertension, or stroke; and having difficulty picking up a coin. Having a good cognition score reduced risk.
The increased risk seen in multi-story-building dwellers may have been due to the “greater physical, social and psychological burdens faced by older adults in these settings,” the researchers say.
The researchers also used a marker of “health shock,” which looked at stroke risk for various time periods after a study participant had been hospitalized for something other than a stroke, ranging from seven days up to two years. They found that patients’ stroke risk was 200 percent to 480 percent higher in the week after hospital discharge.
“This suggests that post-discharge planning and monitoring for a week or so following hospital discharge for something other than a stroke might be fruitful and might potentially reduce the risk of subsequent stroke during this transition period,” the researchers conclude.
SOURCE: BMC Geriatrics, online May 9, 2009.
