The association of post-stroke changes in body mass index with activity of daily living and instrumental activity of daily living trajectories: A multi-cohort analysis
Por:
Chambinaud G, Fayosse A, Dugravot A, Landré B, Schnitzler A, Singh-Manoux A, Sabia S and Jacob L.
Publicada:
1 feb 2026
Ahead of Print:
1 ene 2026
Resumen:
Objectives: The determinants of functional limitation trajectories after stroke remain scarce. This study aimed to investigate the association of early body mass index (BMI) changes with trajectories of activities of daily living (ADLs) and instrumental activities of daily living (IADLs) following stroke. Design: Three cohorts from Europe and the United States. Setting: Community. Participants: Stroke survivors. Measurements: BMI changes were assessed 1-4 years after self-reported stroke and categorized as decreased (<=-5% initial BMI), increased (>= 5% initial BMI), and stable. An alternate cut-point of 2% was also used. Functional limitations were measured as the number of ADL and IADL limitations, which were repeatedly measured for up to 24 years after stroke. Associations were evaluated using segmented linear mixed-effects models after adjusting for demographic, behavioral, and medical factors. Results: The study population comprised 2544 adults with stroke (mean [standard deviation] age 70.0 [10.9] years; 52.0% women). Based on a 5% cutoff, the number of ADL and IADL limitations was higher in the groups of decreased (ADL: 0.56 [95% CI = 0.28, 0.85]; IADL: 0.66 [95% CI = 0.38, 0.94]) and increased BMI (ADL: 0.55 [95% CI = 0.28, 0.81]; IADL: 0.59 [95% CI = 0.33, 0.85]) compared to stable BMI, respectively. Similar findings were obtained for a 2% cutoff. These differences frequently persisted for 24 years for decreased BMI and 6-12 years for increased BMI. Conclusion: Early decreased BMI, and to a lesser extent increased BMI, following stroke could be a marker of longterm adverse trajectories of physical functioning, underlying the importance of nutritional and physical activity management after a stroke.
Filiaciones:
Chambinaud G:
Université Paris Cité, INSERM U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Paris, France
Fayosse A:
Université Paris Cité, INSERM U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Paris, France
Dugravot A:
Université Paris Cité, INSERM U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Paris, France
Landré B:
Université Paris Cité, INSERM U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Paris, France
Schnitzler A:
Université Paris Cité, INSERM U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Paris, France
Assistance Publique - Hôpitaux de Paris (AP-HP), Université Paris Cité, Lariboisière-Fernand Widal Hospital, Department of Physical Medicine and Rehabilitation, Paris, France
Singh-Manoux A:
Université Paris Cité, INSERM U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Paris, France
Faculty of Brain Sciences, University College London, United Kingdom
Sabia S:
Université Paris Cité, INSERM U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Paris, France
Faculty of Brain Sciences, University College London, United Kingdom
Jacob L.:
Assistance Publique - Hôpitaux de Paris (AP-HP), Université Paris Cité, Lariboisière-Fernand Widal Hospital, Department of Physical Medicine and Rehabilitation, Paris, France
Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain
Université Paris Cité, INSERM U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Paris, France
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