Background: Stroke is a leading cause of disability, with older patients often facing more profound functional impairments. We sought to identify psychosocial resilience factors that may contribute to positive functional and quality of life outcomes in older stroke patients. Methods: From an ongoing population-based stroke surveillance study in South Texas, the Brain Attack Surveillance in Corpus Christi (BASIC) Project, we identified first-ever ischemic stroke patients aged ≥65 from October 2019-December 2024. Candidate resilience factors were ascertained from patient interviews conducted shortly after the stroke, and included educational attainment, self-reported annual household income, marital status, social support, insurance type, regular physician access, sleep quantity, and bilingualism. Our primary outcomes were functional status and quality of life, ascertained via follow-up interviews approximately 90 days following the index stroke event. Functional status was evaluated using a 22-item activities of daily living/instrumental activities of daily living scale (ADL/IADL; range 1-4; higher score=worse function). Quality of life was assessed using the Stroke-Specific Quality of Life Scale (SS-QOL; range 1-5; higher score=better QOL). Multivariable linear regression models were used to jointly model the association of candidate resilience factors with each outcome, controlling for clinical and sociodemographic factors, including pre-stroke functional status. Results: A total of 769 ischemic stroke patients aged ≥65 participated from 2019-2024. Participants had a mean (SD) age of 75 (7), were 49% female, and 55% Mexican American. Mean (SD) ADL/IADL functional rating was 2. 34 (1. 00), while mean (SD) SS-QOL score was 3. 35 (1. 09). Regression model parameters are shown in the Table. In the primary analysis, a self-reported income of 50, 000+ was associated with better ADL/IADL (β= -0. 48; 95% CI= -0. 76, -0. 19, p<0. 01) and SS-QOL scores (β=0. 44; 95% CI=0. 15- 0. 73, p<0. 01). None of the other candidate resilience factors were associated with either outcome. Conclusions: In this population-based study of 90-day post-stroke outcomes among older stroke survivors, we found that patients who reported higher incomes had better functional and quality of life outcomes. Other psychosocial factors were not associated with post-stroke outcomes. These findings highlight the influence of socioeconomic factors on stroke recovery.
Nigoghosian et al. (Thu,) studied this question.