Mandip S Dhamoon1, Yeseon Park Moon2, Myunghee C Paik2, Ralph L Sacco3, Mitchell S V Elkind4. 1. Department of Neurology, Mount Sinai School of Medicine, New York, NY. Electronic address: mandip.dhamoon@mssm.edu. 2. Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY. 3. Department of Neurology, Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, FL; Department of Public Health Sciences and Human Genetics, Miller School of Medicine, University of Miami, FL; Department of Human Genetics, Miller School of Medicine, University of Miami, FL. 4. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY.
Abstract
PURPOSE: There are limited data on vascular predictors of long-term disability in Hispanics. We hypothesized that (1) functional status declines over time and (2) vascular risk factors predict functional decline. METHODS: The Northern Manhattan Study contains a population-based study of 3298 stroke-free individuals aged 40 years or older, followed for median 11 years. The Barthel Index (BI) was assessed annually. Generalized estimating equations and Cox models were adjusted for demographic, medical, and social risk factors. Stroke and myocardial infarction occurring during follow-up were censored in sensitivity analysis. Secondarily, motor and nonmotor domains of the BI were analyzed. RESULTS: Mean age (standard deviation) of the cohort (n = 3298) was 69.2 (10) years, 37% were male, 52% Hispanic, 22% diabetic, and 74% hypertensive. There was a mean annual decline of 1.02 BI points (P < .0001). Predictors of decline in BI included age, female sex, diabetes, depression, and normocholesterolemia. Results did not change with censoring. We found similar predictors of BI for motor and nonmotor domains. CONCLUSION: In this large, population-based, multiethnic study with long-term follow-up, we found a 1% mean decline in function per year that did not change when vascular events were censored. Diabetes predicted functional decline in the absence of clinical vascular events.
PURPOSE: There are limited data on vascular predictors of long-term disability in Hispanics. We hypothesized that (1) functional status declines over time and (2) vascular risk factors predict functional decline. METHODS: The Northern Manhattan Study contains a population-based study of 3298 stroke-free individuals aged 40 years or older, followed for median 11 years. The Barthel Index (BI) was assessed annually. Generalized estimating equations and Cox models were adjusted for demographic, medical, and social risk factors. Stroke and myocardial infarction occurring during follow-up were censored in sensitivity analysis. Secondarily, motor and nonmotor domains of the BI were analyzed. RESULTS: Mean age (standard deviation) of the cohort (n = 3298) was 69.2 (10) years, 37% were male, 52% Hispanic, 22% diabetic, and 74% hypertensive. There was a mean annual decline of 1.02 BI points (P < .0001). Predictors of decline in BI included age, female sex, diabetes, depression, and normocholesterolemia. Results did not change with censoring. We found similar predictors of BI for motor and nonmotor domains. CONCLUSION: In this large, population-based, multiethnic study with long-term follow-up, we found a 1% mean decline in function per year that did not change when vascular events were censored. Diabetes predicted functional decline in the absence of clinical vascular events.
Authors: Joshua Z Willey; Norbelina Disla; Yeseon Park Moon; Myunghee C Paik; Ralph L Sacco; Bernadette Boden-Albala; Mitchell S V Elkind; Clinton B Wright Journal: Stroke Date: 2010-07-29 Impact factor: 7.914
Authors: J P Mohr; J L Thompson; R M Lazar; B Levin; R L Sacco; K L Furie; J P Kistler; G W Albers; L C Pettigrew; H P Adams; C M Jackson; P Pullicino Journal: N Engl J Med Date: 2001-11-15 Impact factor: 91.245
Authors: Rita Rastogi Kalyani; Christopher D Saudek; Frederick L Brancati; Elizabeth Selvin Journal: Diabetes Care Date: 2010-02-25 Impact factor: 19.112
Authors: Mandip S Dhamoon; Yeseon Park Moon; Myunghee C Paik; Bernadette Boden-Albala; Tatjana Rundek; Ralph L Sacco; Mitchell S V Elkind Journal: Stroke Date: 2009-06-25 Impact factor: 7.914
Authors: Erin R Kulick; Yeseon P Moon; Ken Cheung; Joshua Z Willey; Ralph L Sacco; Mitchell S V Elkind Journal: Prev Med Date: 2015-12-04 Impact factor: 4.018
Authors: Mandip S Dhamoon; Ying-Kuen Cheung; Yeseon P Moon; Clinton B Wright; Joshua Z Willey; Ralph Sacco; Mitchell Sv Elkind Journal: Age Ageing Date: 2017-01-15 Impact factor: 10.668
Authors: Mandip S Dhamoon; Ying-Kuen Cheung; Jose Gutierrez; Yeseon P Moon; Ralph L Sacco; Mitchell S V Elkind; Clinton B Wright Journal: Stroke Date: 2018-01-26 Impact factor: 7.914
Authors: Renata Tiene de Carvalho Yokota; Lenildo de Moura; Silvânia Suely Caribé de Araújo Andrade; Naíza Nayla Bandeira de Sá; Wilma Johanna Nusselder; Herman Van Oyen Journal: Int J Public Health Date: 2016-06-23 Impact factor: 3.380
Authors: Mandip S Dhamoon; Ying-Kuen Cheung; Ahmet Bagci; Noam Alperin; Ralph L Sacco; Mitchell S V Elkind; Clinton B Wright Journal: Front Aging Neurosci Date: 2017-09-20 Impact factor: 5.750