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Associations Between Positive Emotion and Recovery of Functional Status Following Stroke

From the Sealy Center on Aging (G.V.O., K.J.O.), Division of Geriatrics, Department of Medicine (G.V.O., I.-M.B., M.E.O.), Department of Preventive Medicine and Community Health (G.V.O., I.-M.B.), Department of Psychology (A.C.), University of Westminster, London, United Kingdom; and Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, Texas (K.J.O.).

Address correspondence and reprint requests to Glenn V. Ostir, PhD, UTMB, 301 University Blvd., Galveston, TX 77555-0460. E-mail: gostir{at}utmb.edu

Objective: Accumulating evidence indicates the beneficial effects of positive emotion on health and general well-being in older age. Less evidence is available on whether positive emotion supports improvement in functional status after an acute medical event such as stroke. This study examined the association between positive emotion at discharge from inpatient medical rehabilitation and functional status 3 months later in persons with stroke.

Methods: A longitudinal study using information from the Stroke Recovery in Underserved Patients database. The study included 823 persons aged 55 years or older with stroke and admitted to an inpatient medical rehabilitation facility. Information was collected during inpatient medical rehabilitation stay and approximately 3 months after discharge.

Results: The mean age of the sample was 72.8 years (SD = 9.5), 51.5% were women and 53.8% were married. The sample was mostly non-Hispanic white (79.2%), followed by non-Hispanic black (15.0%) and Hispanic (5.8%). The average length of stay was 20.1 day (SD = 10.1). In multivariate regression analyses, discharge positive emotion score was significantly associated with higher overall functional status (b = 0.70, SE = 0.21, p = .001) as well as with higher motor (b = 0.37, SE = 0.17, p = .003) and cognitive (b = 0.30, SE = 0.05, p = .0001) status at 3-month follow-up after adjustment for relevant risk factors.

Conclusions: Our results indicate positive emotion is associated with gains in functional status after stroke. Findings have implications for stroke recovery programs and suggest the need to include measures of positive emotion inpatient assessments.

Key Words: positive affect • cerebrovascular accident • recovery of function

Abbreviations: CES-D = Center for Epidemiologic Studies-Depression; CMS = Centers for Medicare and Medicaid Services; FIM = Functional Independence Measure; IRF-PAI = Inpatient Rehabilitation Facilities-Patient Assessment Instrument; SE = standard error; SRUP = Stroke Recovery in Underserved Populations.

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