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Peer-reviewedCC BYENeurologicalSci

Pre-stroke frailty in patients with first-ever acute stroke: Its associations with stroke subtype and impact on activities of daily living.

  • Tatsuya Iwasawa1,2
  • Yoichiro Aoyagi1,2
  • Yuki Sakamoto3
  • Miho Ohashi1,2
  • Satoshi Ikeda1,2
  • Tomonari Saito3
  • Takashi Shimoyama3
  • Satoshi Suda3
  1. 1Department of Rehabilitation Medicine, Nippon Medical School Hospital, Tokyo, Japan.
  2. 2Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
  3. 3Department of Neurology, Nippon Medical School, Tokyo, Japan.
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Abstract

Objective

Few studies have examined frailty in patients with first-ever stroke who were independent in activities of daily living (ADLs) prior to onset. This study aimed to investigate the characteristics of pre-stroke frailty and its impact on ADLs at discharge.Methods

In this prospective cohort study, 152 patients aged ≥65 years with first-ever stroke admitted to the stroke unit of a university hospital were enrolled. Pre-frailty/frailty was assessed using the Clinical Frailty Scale (CFS). Associations between frailty status and clinical characteristics were evaluated. Multivariate regression analysis identified independent predictors of the Barthel Index (BI) at discharge.Results

Pre-frailty/frailty was present in 35.5% of patients, and was associated with higher rates of atrial fibrillation (p = 0.043) and cardioembolic stroke (p = 0.001). Compared with the robust group, the pre-frailty/frailty group had significantly lower BI scores at both admission and discharge, as well as more extended hospital stays. Both groups, however, demonstrated significant improvement in BI at discharge (p < 0.001). Multivariate analysis revealed that NIH Stroke Scale score (p < 0.001), stroke type (p = 0.010), and CFS score (p = 0.044) independently predicted BI at discharge.Conclusion

Pre-stroke frailty is associated with a higher risk of cardioembolic stroke and poorer functional status during hospitalization. Nevertheless, patients with frailty still achieved significant ADL improvement with rehabilitation, underscoring the importance of active rehabilitation strategies in this population.

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Cite

BibTeXRIS
BibTeX
@article{iwasawa2026prestroke,
  title = {{Pre-stroke frailty in patients with first-ever acute stroke: Its associations with stroke subtype and impact on activities of daily living.}},
  author = {Tatsuya Iwasawa and Yoichiro Aoyagi and Yuki Sakamoto and Miho Ohashi and Satoshi Ikeda and Tomonari Saito and Takashi Shimoyama and Satoshi Suda},
  journal = {ENeurologicalSci},
  year = {2026},
  month = oct,
  doi = {10.1016/j.ensci.2026.100626},
  url = {https://europepmc.org/article/MED/42927051},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Pre-stroke frailty in patients with first-ever acute stroke: Its associations with stroke subtype and impact on activities of daily living.
AU  - Tatsuya Iwasawa
AU  - Yoichiro Aoyagi
AU  - Yuki Sakamoto
AU  - Miho Ohashi
AU  - Satoshi Ikeda
AU  - Tomonari Saito
AU  - Takashi Shimoyama
AU  - Satoshi Suda
PY  - 2026
DA  - 2026/10/16
JO  - ENeurologicalSci
DO  - 10.1016/j.ensci.2026.100626
UR  - https://europepmc.org/article/MED/42927051
AB  - Objective  Few studies have examined frailty in patients with first-ever stroke who were independent in activities of daily living (ADLs) prior to onset. This study aimed to investigate the characteristics of pre-stroke frailty and its impact on ADLs at discharge.Methods  In this prospective cohort study, 152 patients aged ≥65 years with first-ever stroke admitted to the stroke unit of a university hospital were enrolled. Pre-frailty/frailty was assessed using the Clinical Frailty Scale (CFS). Associations between frailty status and clinical characteristics were evaluated. Multivariate regression analysis identified independent predictors of the Barthel Index (BI) at discharge.Results  Pre-frailty/frailty was present in 35.5% of patients, and was associated with higher rates of atrial fibrillation (p = 0.043) and cardioembolic stroke (p = 0.001). Compared with the robust group, the pre-frailty/frailty group had significantly lower BI scores at both admission and discharge, as well as more extended hospital stays. Both groups, however, demonstrated significant improvement in BI at discharge (p < 0.001). Multivariate analysis revealed that NIH Stroke Scale score (p < 0.001), stroke type (p = 0.010), and CFS score (p = 0.044) independently predicted BI at discharge.Conclusion  Pre-stroke frailty is associated with a higher risk of cardioembolic stroke and poorer functional status during hospitalization. Nevertheless, patients with frailty still achieved significant ADL improvement with rehabilitation, underscoring the importance of active rehabilitation strategies in this population.
SN  - 2405-6502
ER  -