This study investigated the prevalence of frailty and pre-onset living conditions in patients with MIS and transient ischemic attack (TIA).
In this single-center retrospective case-control study, patients with acute MIS and TIA were enrolled. Eligibility criteria included discharge to home and an mRS score of 0–2. Patients with a Mini-Mental State Examination (MMSE) score of 17 or lower were excluded. Frailty was assessed using the Japanese Cardiovascular Health Study (J-CHS) criteria, classifying patients as robust, pre-frail, or frail. Data collected included age, National Institutes of Health Stroke Scale (NIHSS), MMSE, handgrip strength (HG), knee extensor isometric muscle strength (KEIMS), 10-meter walking speed (WS), and pre-onset living conditions. Pre-onset living conditions were assessed using the "Kihon Checklist" (KCL), composed of 25 questions across seven domains: five on activities of daily living (ADLs), five on physical strength, two on nutrition, three on oral function, two on isolation, three on memory, and five on mood (Arai H, et al. Geriatr Gerontol Int 2015; 15: 518-519). Statistical analyses were performed to compare the three groups of J-CHS criteria using the chi-square test, Fisher’s exact test, Kruskal–Wallis test, and Bonferroni's multiple comparison test. A p value .05 was considered statistically significant.
A total of 367 patients (225 men, mean age 69.7±13.0 years) were included in this study. According to the J-CHS criteria, 90 patients (25%) were classified as robust, 200 (54%) as pre-frail, and 77 (21%) as frail. The frail group had significantly lower MMSE (p 0.001), HG (p 0.001), KEIMS (p 0.001), and WS (p 0.001) scores. In pre-onset living conditions, the frail group showed significant differences in the following items: "go shopping" under ADLs; all five items of physical strength; "weight loss" under nutrition; "going out at least once a week" and "going out less frequently" under isolation; "knowing today's date" under memory; and all five items under mood.
The prevalence of frailty in patients with MIS and TIA was 21%, which is similar to that in previously reported acute stroke studies. Patients with MIS and TIA with frailty were found to have not only physical, but also social and psychological problems in their pre-onset living conditions. Therefore, psychosocial support may be necessary when planning rehabilitation treatments aimed at improving physical function and activity levels.
Rehabilitation treatment in patients with MIS and TIA should address not only physical problems but also the social and psychological aspects that exist before onset.
frailty
Kihon Checklist Topic
