Pre-Stroke Frailty and Stroke Severity in Elderly Patients with Acute Stroke

Abstract

Objective: Frailty is a major problem in super-aged societies. Because frailty assessments are largely unstudied in acute stroke settings, few reports have evaluated the association between pre-stroke frailty and stroke severity. The aim of this study was to determine the association between pre-stroke frailty and stroke severity in elderly patients with acute stroke.

Materials and methods: This cross-sectional study enrolled consecutive elderly patients with acute stroke. We assessed stroke severity with the National Institutes of Stroke Scale (NIHSS), and pre-stroke frailty with a Frailty Screening Index in elderly patients with acute stroke. Patients were divided according to their Frailty Screening Index: the robust group, pre-frailty group, and frailty group. Multiple linear regression analysis was used to determine whether pre-stroke frailty was independently associated with NIHSS score.

Results: In total, 234 elderly patients with acute stroke (age: 75.7 years; 149 men, 85 women) were enrolled in this study. Of these, the robust group comprised 76 patients, the pre-frailty group comprised 129 patients, and the frailty group comprised 29 patients. The prevalence of pre-stroke frailty was 12.4%. Multiple linear regression analysis showed that pre-stroke pre-frailty and frailty were significantly associated with NIHSS score (pre-frailty; β = 1.191, P = .005, frailty; β = 1.708, P = .009).

Conclusions: The present study indicated that the pre-stroke frailty was significantly associated with stroke severity in elderly patients with acute stroke. Additional study is needed to clarify the association between pre-stroke frailty and post-stroke prognosis.

Keywords: Elderly; Frailty; Risk factor; Severity; Stroke.