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Cognitive impairment after stroke - impact on activities of daily living and costs of care for elderly people. The Göteborg 70+ Stroke Study.

Journal article
Authors Lisbeth Claesson
Thomas Lindén
Ingmar Skoog
Christian Blomstrand
Published in Cerebrovascular diseases (Basel, Switzerland)
Volume 19
Issue 2
Pages 102-9
ISSN 1015-9770
Publication year 2005
Published at Institute of Clinical Neurosciences, Section of Neurological Diseases
Institute of Clinical Neurosciences, Section of Psychiatry
Pages 102-9
Language en
Links dx.doi.org/10.1159/000082787
Keywords Activities of Daily Living, Aged, Aged, 80 and over, Cerebrovascular Accident, economics, psychology, therapy, Cognition Disorders, economics, etiology, therapy, Cohort Studies, Female, Health Care Costs, Health Resources, economics, utilization, Humans, Male, Severity of Illness Index
Subject categories Neurology, Psychiatry, Health Care Service and Management, Health Policy and Services and Health Economy, Occupational Therapy, Older people and ageing

Abstract

BACKGROUND AND PURPOSE: The economic burden of stroke is substantial and is likely to increase with an increasing number of elderly individuals in the population. There is thus a need for information on the use of health care resources and costs among these elderly stroke patients. We examined the impact of the cognitive impairments on the ability to perform activities of daily living (ADL) and utilization and costs of health care in a cohort of elderly stroke patients. METHODS: One hundred and forty-nine patients aged >/=70 years with acute stroke were included. The patients were assessed regarding their ability to carry out ADL and health resource utilization and cost during the first year after stroke. Cognitive impairments were assessed 18 months after the index stroke. RESULTS: Stroke severity in acute stroke and cognitive impairment at 18 months after stroke onset was associated with impairment in ADL and increased costs for utilisation of care during the first year. Patients with cognitive impairment were more dependent on personal assistance in ADL. Costs per patient during the study were three times higher for patients with cognitive impairment. Hospital care, institutional living and different kinds of support from society accounted for the highest costs. CONCLUSIONS: Costs of care utilisation during the first year after stroke were associated with cognitive impairments, stroke severity and dependence in ADL. The results should be interpreted cautiously as the assessment of cognitive function was made 18 months after stroke onset and costs were estimated for the first year after stroke.

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