4.5 Article

Regular physical activity postpones age of occurrence of first-ever stroke and improves long-term outcomes

Journal

NEUROLOGICAL SCIENCES
Volume 42, Issue 8, Pages 3203-3210

Publisher

SPRINGER-VERLAG ITALIA SRL
DOI: 10.1007/s10072-020-04903-7

Keywords

Stroke; Physical activity; Disability; Functional dependency; Death; Recurrence; Population-based study

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This study found that among stroke patients, inactive individuals were younger at the age of first stroke occurrence and had a higher risk of mortality at 1 and 5 years compared to active individuals, while other outcomes did not show significant differences.
Objective Few data are available on the associations between the level of pre-stroke physical activity and long-term outcomes in patients with stroke. This study is designed to assess the associations between pre-stroke physical activity and age of first-ever stroke occurrence and long-term outcomes. Methods Six hundred twenty-four cases with first-ever stroke were recruited from the Mashhad Stroke Incidence Study a prospective population-based cohort in Iran. Data on Physical Activity Level (PAL) were collected retrospectively and were available in 395 cases. According to the PAL values, subjects were classified as inactive (PAL < 1.70) and active (PAL >= 1.70). Age at onset of stroke was compared between active and inactive groups. Using logistic model, we assessed association between pre-stroke physical activity and long-term (5-year) mortality, recurrence, disability, and functional dependency rates. We used multiple imputation to analyze missing data. Results Inactive patients (PAL < 1.70) were more than 6 years younger at their age of first-ever-stroke occurrence (60.7 +/- 15.5) than active patients (67.0 +/- 13.2; p < 0.001). Patients with PAL< 1.7 also had a greater risk of mortality at 1 year [adjusted odds ratio (aOR) = 2.31; 95%CI: 1.14-4.67, p = 0.02] and 5 years after stroke (aOR = 1.81; 95%CI: 1.05-3.14, p = 0.03) than patients who were more physically active. Recurrence rate, disability, and functional dependency were not statistically different between two groups. Missing data analysis also showed a higher odds of death at one and 5 years for inactive patients. Conclusions In our cohort, we observed a younger age of stroke and a higher odds of 1- and 5-year mortality among those with less physical activity. This is an important health promotion strategy to encourage people to remain physically active.

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