Regular physical activity postpones age of occurrence of first-ever stroke and improves long-term outcomes
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ORIGINAL ARTICLE
Regular physical activity postpones age of occurrence of first-ever stroke and improves long-term outcomes Negar Morovatdar 1 & Mario Di Napoli 2,3 & Saverio Stranges 4,5,6 & Amanda G. Thrift 7 & Moira Kapral 8,9 & Reza Behrouz 10 & Mohammad Taghi Farzadfard 11 & Mohammad Sobhan Sheikh Andalibi 12 & Reza Rahimzadeh Oskooie 12 & Anuradha Sawant 13 & Naghmeh Mokhber 14,15 & M. Reza Azarpazhooh 4,11,13 Received: 30 September 2019 / Accepted: 11 November 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Objective Few data are available on the associations between the level of pre-stroke physical activity and long-term outcomes in patients with stroke. This study is designed to assess the associations between pre-stroke physical activity and age of first-ever stroke occurrence and long-term outcomes. Methods Six hundred twenty-four cases with first-ever stroke were recruited from the Mashhad Stroke Incidence Study a prospective population-based cohort in Iran. Data on Physical Activity Level (PAL) were collected retrospectively and were available in 395 cases. According to the PAL values, subjects were classified as inactive (PAL < 1.70) and active (PAL ≥ 1.70). Age at onset of stroke was compared between active and inactive groups. Using logistic model, we assessed association between pre-stroke physical activity and long-term (5-year) mortality, recurrence, disability, and functional dependency rates. We used multiple imputation to analyze missing data. Results Inactive patients (PAL < 1.70) were more than 6 years younger at their age of first-ever-stroke occurrence (60.7 ± 15.5) than active patients (67.0 ± 13.2; p < 0.001). Patients with PAL< 1.7 also had a greater risk of mortality at 1 year [adjusted odds ratio (aOR) = 2.31; 95%CI: 1.14–4.67, p = 0.02] and 5 years after stroke (aOR = 1.81; 95%CI: 1.05–3.14, p = 0.03) than patients who were more physically active. Recurrence rate, disability, and functional dependency were not statistically different between two groups. Missing data analysis also showed a higher odds of death at one and 5 years for inactive patients. Conclusions In our cohort, we observed a younger age of stroke and a higher odds of 1- and 5-year mortality among those with less physical activity. This is an important health promotion strategy to encourage people to remain physically active.
* M. Reza Azarpazhooh [email protected]
8
Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
1
Clinical Research Development Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
9
Institute for Clinical Evaluative Sciences, Toronto, Canada
10
2
Department of Neurology and Stroke Unit, San Camillo de’ Lellis General Hospital, Rieti, Italy
Department of Neurology, Lozano-Long School of Medicine, University of Texas Health, San Antonio, TX, USA
3
Neurological Section, Neuro-epidemiology Unit, SMDN-Centre for Cardiovascular Medicine and Cerebrovascular Disease Preve
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