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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The incidence of incontinence in a series of 135 consecutive stroke patients was 51% (urine) and 23% (feces) within one year. In 75% the urinary incontinence started within the first two weeks, and in 41% it had cleared during that time. Incontinence at onset is associated with measures of severity of stroke (and of immobility for fecal incontinence). Among 92 survivors at one year, 15% were incontinent of urine, a proportion that rose in two- and three-year survivors to 23 to 24%, but by four years was again 14%, a level similar to that of the general elderly population. It is concluded that incontinence is more commonly a by-product of immobility and dependency than of involvement of the neurologic pathways, and most of it is transient.
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PMID:Incidence and correlates of incontinence in stroke patients. 401 99

Data from a sample of 532 patients seen within seven days of an acute stroke has been analysed to compare the prognostic importance of urinary incontinence with that of a history of any depression of consciousness. Urinary incontinence was more specific and had a higher predictive value. Considering conscious patients with moderate or severe initial disability, after six months 53 per cent of incontinent patients had died and 57 per cent of the survivors were still moderately or severely disabled whereas only 19 per cent of continent patients had died and 80 per cent of survivors made a good recovery. We conclude that early urinary incontinence is an important indicator of poor prognosis, identifying patients who may need extra attention.
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PMID:Outlook after an acute stroke: urinary incontinence and loss of consciousness compared in 532 patients. 405 7

Mental illness was recorded in 17% of men and 30% of women at the first examination of a random sample of the population of north Edinburgh consisting of 215 men and 272 women aged 62-90 years. Chronic brain syndrome (CBS) was found in 6% of men and 10.7% of women. CBS severe enough to constitute clinical dementia occurred in 3% of the sample. CBS increased in prevalence with age, particularly in women. Depressive illness was found in 3.7% of men and 6.6% of women. Anxiety states were present in 7% of men and 16.5% of women. Physical health and measurements were recorded in the same random sample in respect of ischaemic heart disease, stroke, blood pressure, chronic bronchitis, respiratory function, visual acuity, audiometry, urinary incontinence and food intake. The physical findings related to CBS were poor vision, poor hearing, urinary incontinence and poor diet. Five years later 113 men and 148 women were re-examined. The annual incidence of CBS was 0.4% in men and 1.4% in women. The annual incidence of depressive illness was 0.8% in both sexes, and of anxiety neurosis was 0.3%. Mortality rates were high in subjects with CBS. All moderate/severe cases of CBS had died by the end of seven years, but 15% of the mild cases were alive after 14 years. Prevalence and incidence of CBS in the study were similar to those reported by other authors. Figures for depressive illness and anxiety neurosis tended to be higher than in other surveys.
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PMID:Mental illness and physical health in older people. 633 87

In 83 patients with stroke, multiple regression analysis was used to identify 5 variables, measured at the 1st assessment shortly after stroke, that related to the Barthel ADL score at 6 months. The variables were age, the presence of hemianopia or visual inattention, the presence of urinary incontinence, the motor deficit in the affected arm, and the patient's sitting balance. A 2nd equation, based upon the initial Barthel score with age and hemianopia added, was also developed. The success of the 1st equation in predicting the final Barthel score was about 55%, a rate better than that yielded by the 2nd equation, and also better than that produced by adding the average improvement score to the patient's initial score.
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PMID:Predicting Barthel ADL score at 6 months after an acute stroke. 684 30

Fifty-three stroke patients with severe functional loss at two weeks, following the stroke were followed up for one year. No improvement occurred in 47% during this time and this was associated with abnormalities of muscle tone, incontinence of urine or faeces, perceptual disorders and previous disabilities affecting locomotion. Remedial therapy continued for long periods especially in the group who did not improve. It is suggested that rehabilitation resources could have been used more appropriately. Further research is required to determine whether intensive therapy is of value in the severely disabled stroke patient especially those with perceptual and cognitive dysfunction.
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PMID:The recovery of the severely disable stroke patient. 713 43

Urinary incontinence and a program to treat it were studied in a geriatric hospital. Of 161 men, 58 (36%) were incontinent. The most common probable causes were cerebrovascular accident and organic brain syndrome. Evaluation by cystometry (after treatment of infections) in 30 patients showed 24 (80%) to have detrusor hyperreflexia. Twenty patients with hyperreflexia completed a timed-voiding routine, which benefited 17 of them (85%).
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PMID:Behavioural treatment of urinary incontinence in geriatric patients. 713 6

The purpose of this retrospective study was to compare the demographic, neurologic, and cognitive characteristics of patients with completed stroke who participated in a behavioral management program for urinary incontinence. The study sought to determine the differences between those patients who achieved continence by the time of discharge from the program and those who did not. A retrospective chart review that used the Functional Independence Measure (FIM) scores identified 75 subjects with urinary incontinence at the time of admission. Forty-two study subjects achieved continence after participating in a rehabilitation and bladder management program. Thirty-three study subjects remained incontinent despite participation in a rehabilitation and bladder management program. Incontinent subjects had more difficulty with orientation to time, memory, and problem solving. These areas of cognitive function appear to have a direct impact on the ability of the person with stroke to achieve continence.
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PMID:A comparison of characteristics of patients with completed stroke: those who achieve continence and those who do not. 761 64

This paper reviews the methodological issues in the epidemiological study of the outcome from stroke. Data are presented from an unselected series of patients in whom the underlying stroke pathology is clearly defined. Although the natural history varies among the different pathological subtypes of stroke, simple clinical baseline measures of the severity of the neurological deficit (incontinence, loss of consciousness and severity of paresis) and premorbid level of disability and social functioning independently predict disability-free survival by 1 year, and may help direct management and research.
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PMID:Baseline measures and outcome predictions. 780 Jan 6

Although diabetes is a common health problem of the elderly, the impact of diabetes on health and functioning in older persons is not well established. The purpose of this analysis was to identify health conditions accompanying diabetes in four samples of community dwelling elderly people. The study samples consisted of 13,601 persons ages 65 or older who participated in the Established Populations for Epidemiologic Studies in the Elderly (EPESE). Extensive interviews were conducted in respondents' homes to obtain information on diabetes and other health conditions, health behaviors, use of health services, and demographic characteristics. A lifetime history of diabetes was reported by 14 percent of respondents. The prevalence of the disease was higher in blacks than whites, especially among women. Persons with diabetes were more likely to report myocardial infarction, stroke, vision problems, physical disability, incontinence, and nursing home stays than persons without diabetes, but the diabetics were less likely to consume alcohol or tobacco. Those with diabetes were only slightly heavier than those without diabetes at the time of the interview. However, body mass at age 50 was substantially greater among persons with diabetes. Associations between diabetes and other health conditions and behaviors were similar for whites and blacks. These results show that aged persons with diabetes experience substantial comorbidity, which has important ramifications for functioning and survival.
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PMID:The health burden of diabetes for the elderly in four communities. 780 Jul 88

The validity of a clinical classification system was assessed for subtypes of cerebral infarction for use in clinical trials of putative stroke therapies and clinical decision making in a population based stroke register (n = 536) compiled in Perth, Western Australia in 1989-90. The Perth Community Stroke Project (PCSS) used definitions and methodology similar to the Oxfordshire Community Stroke Project (OCSP) where the classification system was developed. In the PCSS, 421 cases of cerebral infarction and primary intracerebral haemorrhage (PICH), confirmed by brain imaging or necropsy, were classified into the subtypes total anterior circulation syndrome (TACS), partial anterior circulation syndrome (PACS), lacunar syndrome (LACS), and posterior circulation syndrome (POCS). In this relatively unselected population, relying exclusively on LACS for a diagnosis of PICH had a very low sensitivity (6%) and positive predictive value (3%). Comparison of the frequencies and outcomes (at one year after the onset of symptoms) for each subgroup of first ever cerebral infarction in the PCSS (n = 248) with the OCSP (n = 543) registers showed uniformity only for LACI. For example, there were 27% of cases of TACI in the PCSS compared with 17% in the OCSP (difference = 10%; 95% confidence interval (95% CI) 4% to 16%) and 15% of cases in the PCSS compared with 24% in the OCSP were POCI (difference = 9%; 95% CI 3% to 15%). Case fatalities and long-term handicap across the subgroups were not significantly different between studies, but the frequencies of recurrent stroke were significantly greater for POCI in the OCSP compared with the PCSS. Although this classification system defines subtypes of stroke with different outcomes, simple clinical measures-level of consciousness, paresis, disability, and incontinence at onset-are more powerful predictors of death or dependency at one year. It is concluded that simple clinical measures that reflect the severity of the neurological deficit should complement this classification system in clinical trials and practice.
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PMID:Validation of a clinical classification for subtypes of acute cerebral infarction. 793 76


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