Mexican Americans Fared Worse After Stroke

Mexican Americans had poorer functional and cognitive outcomes after stroke

(RxWiki News) Mexican Americans have a higher stroke risk and tend to live longer after stroke than non-Hispanic whites. But this longer survival may come at a cost.

In a recent study, researchers investigated whether longer survival after a stroke was associated with more post-stroke disability.

This study found that after a stroke, Mexican Americans had more physical and mental disabilities and lower quality of life than non-Hispanic whites.

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A research team led by Lewis B. Morgenstern, MD, and Lynda D. Lisabeth, PhD, from the Department of Epidemiology at the University of Michigan School of Public Health in Ann Arbor, MI, conducted this research.

This study included 842 patients who had had a stroke.  The age range of the study participants was 57 to 78. For purposes of the study, the researchers divided the patients into two groups: Mexican Americans and non-Hispanic whites. In total, 64 percent of the participants were Mexican Americans.

The patients in the Mexican-American group had greater body masses (BMI). Normal BMI ranges from 18.5 to 24.9 kg/m2, while a person with a BMI of 25 to 29.9 is considered overweight, and those with a BMI of 30 or more are considered obese.

The average BMI of the Mexican Americans was 29, compared with 27 among the non-Hispanic whites. There were more current or former smokers in the non-Hispanic white group, with 45 percent versus 30 percent in the Mexican-American group.

Both high body mass and smoking are factors associated with an increased risk for stroke.

At the beginning of the study and 90 days later, the researchers conducted interviews and medical record reviews on the participants. The interviews included three surveys to assess quality of life and amount of mental and physical disability the patients had.

The researchers used a survey to assess activities of daily living, such as bathing, walking, eating and dressing. This survey had a scale of 0 to 4, in which higher scores were worse. A stroke scale (NIHSS) measured brain function by physical and speaking abilities on a scale of 0 to 44, where higher scores were worse. Thinking and memory were tested on another survey (3MSE), which was scored on a scale of 0 to 100 where lower scores were worse.

Results of the surveys at 90 days showed that the Mexican Americans scored worse on all three tests than non-Hispanic whites.

In the Mexican-American group, 31 percent of the patients had post-stroke memory loss (dementia), compared with 25 percent of the non-Hispanic white group. Compared to non-Hispanic whites, Mexican Americans scored 3.4 points worse on the 3MSE scale.

The Mexican-American patients scored 48 percent worse than the non-Hispanic white patients on the stroke scale that measured physical and speaking disability. The Mexican Americans also fared 0.4 points worse on the activities of daily living scale.

“Our current results suggest that this prolonged survival is at the expense of poor outcomes because Mexican American stroke survivors experienced poorer, neurological, functional, and cognitive outcomes than non-Hispanic whites even after adjustment for a comprehensive list of factors,” the authors wrote.

“Given the rapidly growing Mexican-American population, increased stroke risk in this population in combination with prolonged survival and increased disability will result in an escalating number of Mexican-American stroke survivors requiring assistance,” they wrote.

This research was published in the March issue of Stroke.

The research was funded by a grant from the National Institutes of Health (NIH).

Besides NIH funding, the authors disclosed no conflicts of interest.

Review Date: 
March 12, 2014