Mexican-Americans suffer more damage from stroke than non-Hispanic whites but they survive longer.
New University of Michigan research shows that Mexican-Americans had worse neurologic, functional and cognitive outcomes 90 days after stroke compared to non-Hispanic whites.
Although this population has increased risk of stroke, they have a lower chance of dying from one, suggesting that prolonged survival is at the expense of increased disability.
“What we found most notable was the difference in functional outcome,” said Lynda Lisabeth, the study’s lead author and interim chair and associate professor of epidemiology at the U-M School of Public Health. “Mexican-Americans did worse on all the measures of daily living activities compared to non-Hispanic whites.”
The study is published in the American Heart Association journal Stroke. Among the findings:
• Mexican-Americans had moderate functional disability and nearly one-third had post-stroke dementia.
• Mexican-Americans had a 48 percent worse neurologic outcome score compared to non-Hispanic whites on the National Institutes of Health Stroke Scale. They also scored worse on language dysfunction and several other items from this scale.
• Mexican-Americans had worse cognitive outcome on the Modified Mini-Mental State Examination.
Study participants were drawn from the Brain Attack Surveillance in Corpus Christi project conducted in a non-immigrant south Texas community. Researchers assessed neurologic outcome for 513 people, functional outcome for 510 people and cognitive effects for 415 people (64 percent were Mexican-American).
Mexican-American stroke survivors were younger with a median age of 65, compared to a median 72 years for non-Hispanic whites. Women represented about half of those in the study.
Lisabeth and colleagues analyzed functional outcome by the activities of daily living score (ADL) and the instrumental activities of daily living score (IADL). The ADL score measures seven functional activities: walking, bathing, grooming, eating, dressing, moving and toileting. The IADL score includes 15 questions related to daily functioning.
The level of functional impairment among Mexican-Americans was substantial. This is important given increasing functional impairment is highly predictive of nursing home admission and the need for informal care, the researchers said.
“This study provides the first piece of information on the prognosis of Mexican-American stroke survivors,” Lisabeth said. “The clinical and public health information we discovered is important for future research in stroke prevention and rehabilitation in stroke survivors.
“We don’t yet have a complete picture of recovery for Mexican-Americans and what potential intervention strategies can improve their recovery.”
Co-authors are Brisa Sanchez, Jonggyu Baek, Dr. Lesli Skolarus, Melinda Smith, Nelda Garcia, Dr. Devin Brown, and Dr. Lewis Morgenstern. The National Institutes of Health funded the study.