Ryan R Bailey1, Monica C Serra2, Ryan P McGrath3. 1. Department of Occupational Science and Occupational Therapy, Saint Louis University, 3437 Caroline St, Allied Health Building Room 2020, St. Louis, MO, 63104, USA. Electronic address: ryan.r.bailey@health.slu.edu. 2. Department of Medicine, Division of Geriatrics, Gerontology & Palliative Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA; San Antonio Geriatric Research Education and Clinical Center, South Texas Veterans Health Care System, 7400 Merton Minter, San Antonio, TX, 78229, USA. Electronic address: serram@uthscsa.edu. 3. Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, NDSU Dept. 2620, PO Box 6050, Fargo, ND, 58108, USA. Electronic address: ryan.mcgrath@ndsu.edu.
Abstract
BACKGROUND: Stroke is the most common cause of complex disability. Obesity and diabetes increase risk for functional disability in the general population, but their contribution to functional disability in stroke survivors is unknown. OBJECTIVE: To investigate the joint association of obesity and diabetes with functional disability in stroke survivors. METHODS: Cross-sectional data from 34,376 stroke survivors from the 2015 and 2017 Behavioral Risk Factor Surveillance System (BRFSS) surveys were examined. Weighted and age-adjusted prevalence estimates and adjusted odds ratios (AOR, adjusted for sociodemographic characteristics) with 95% confidence intervals (CIs) were calculated to compare prevalence and odds for self-reported functional disability, stratified by obesity-diabetes status (i.e., neither condition, obesity only, diabetes only, both conditions). RESULTS: Prevalence of functional disability increased across obesity-diabetes categories in the total sample: neither condition (45.4%, 95% CI: 43.4%-47.4%), obesity only (55.3%, 95% CI: 52.7%-58.0%), diabetes only (60.8%, 95% CI: 57.5%-64.1%), and both conditions (70.3%, 95% CI: 67.7%-72.9%). Compared to respondents with neither condition, those with both obesity and diabetes had 2.62 (95% CI: 2.23-3.08) higher odds for functional disability; odds were also increased for respondents with obesity only (1.52, 95% CI: 1.32-1.76) and diabetes only (1.71, CI: 1.45-2.01). CONCLUSIONS: Our findings indicated a joint effect of obesity and diabetes on functional disability that exceeded either condition alone, placing stroke survivors with both health conditions at greatest risk for diminished functional capacity. Recognizing obesity and diabetes as modifiable risk factors may be useful for identifying stroke sub-populations that could benefit from lifestyle intervention.
BACKGROUND:Stroke is the most common cause of complex disability. Obesity and diabetes increase risk for functional disability in the general population, but their contribution to functional disability in stroke survivors is unknown. OBJECTIVE: To investigate the joint association of obesity and diabetes with functional disability in stroke survivors. METHODS: Cross-sectional data from 34,376 stroke survivors from the 2015 and 2017 Behavioral Risk Factor Surveillance System (BRFSS) surveys were examined. Weighted and age-adjusted prevalence estimates and adjusted odds ratios (AOR, adjusted for sociodemographic characteristics) with 95% confidence intervals (CIs) were calculated to compare prevalence and odds for self-reported functional disability, stratified by obesity-diabetes status (i.e., neither condition, obesity only, diabetes only, both conditions). RESULTS: Prevalence of functional disability increased across obesity-diabetes categories in the total sample: neither condition (45.4%, 95% CI: 43.4%-47.4%), obesity only (55.3%, 95% CI: 52.7%-58.0%), diabetes only (60.8%, 95% CI: 57.5%-64.1%), and both conditions (70.3%, 95% CI: 67.7%-72.9%). Compared to respondents with neither condition, those with both obesity and diabetes had 2.62 (95% CI: 2.23-3.08) higher odds for functional disability; odds were also increased for respondents with obesity only (1.52, 95% CI: 1.32-1.76) and diabetes only (1.71, CI: 1.45-2.01). CONCLUSIONS: Our findings indicated a joint effect of obesity and diabetes on functional disability that exceeded either condition alone, placing stroke survivors with both health conditions at greatest risk for diminished functional capacity. Recognizing obesity and diabetes as modifiable risk factors may be useful for identifying stroke sub-populations that could benefit from lifestyle intervention.
Authors: Walter N Kernan; Bruce Ovbiagele; Henry R Black; Dawn M Bravata; Marc I Chimowitz; Michael D Ezekowitz; Margaret C Fang; Marc Fisher; Karen L Furie; Donald V Heck; S Claiborne Clay Johnston; Scott E Kasner; Steven J Kittner; Pamela H Mitchell; Michael W Rich; DeJuran Richardson; Lee H Schwamm; John A Wilson Journal: Stroke Date: 2014-05-01 Impact factor: 7.914
Authors: James H Rimmer; Edward Wang; Christine A Pellegrini; Carolyn Lullo; Ben S Gerber Journal: Am J Phys Med Rehabil Date: 2013-12 Impact factor: 2.159