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Abstract Details

The Association between Physical Activity and Mortality among Community-dwelling Stroke Survivors
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
169
We sought to determine the relationship between physical activity and mortality in community-dwelling stroke survivors.
Epidemiological studies have shown a strong association between physical activity and lower mortality in the general population.  Whether the mortality benefit of physical activity extends to people with prior stroke is poorly understood.
We used the Canadian Community Health Survey (years 2009, 2010, 2013, 2014) linked with administrative databases to identify respondents with prior stroke using validated diagnostic codes and compare to a control group without prior stroke.  Physical activity was calculated as metabolic equivalents (METs) multiplied by the frequency and duration of activity per week.  Minimal adherence to guidelines was defined as 10 MET*hours/week.  We used Cox proportional hazard models and splines to determine the association between physical activity and mortality from survey response until December 2017, adjusting for age, sex, heart disease, lung disease, smoking, and functional limitations (including vision, hearing, speech, mobility, dexterity, emotion, cognition, and pain).  We applied survey weights to attain population representativeness.
Our cohort was representative of 90,000 Canadians with stroke and 12,664,000 controls, with median follow-up of 5 years.  Adhering to physical activity guidelines was associated with lower hazard of death for those with prior stroke (0.43, 95% CI 0.27-0.68) and controls (0.65, 95% CI 0.59-0.71), with no significant effect modification by stroke status. There was a strong dose-response relationship in both groups, with a steep early slope and the vast majority of risk reduction occurring between 0 and 20 MET*hours/week (equivalent to 7 hours of walking).
Physical activity was associated with lower mortality in a dose-dependent manner among community dwelling stroke survivors after adjustment for baseline factors and functional limitations, which did not differ from people without prior stroke.  Our findings encourage implementation of physical activity programs for stroke survivors in the community to reduce long-term mortality. 
Authors/Disclosures
Raed Joundi, MD, PhD
PRESENTER 		Dr. Joundi has nothing to disclose.
Scott Patten, PhD (Univ of Calgary, Community Health Sciences) Dr. Patten has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Canadian Psychiatric Association. Dr. Patten has received publishing royalties from a publication relating to health care.
No disclosure on file
No disclosure on file
Eric E. Smith, MD (University of Calgary) Dr. Smith has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association. Dr. Smith has received publishing royalties from a publication relating to health care. Dr. Smith has received publishing royalties from a publication relating to health care.