Functioning and Disability
Sook Joung Lee, MD., PhD.
Associate Professor/ Dr.
Tha Catholic University of Korea
Daejeon, Taejon-jikhalsi, Republic of Korea
Eun-seok Choi, MD., PhD.
Professor/ Dr.
Catholic University of Korea
Daejeon, Taejon-jikhalsi, Republic of Korea
Sodam Kim, MD
Dr
Catholic University of Korea
Daejeon, Taejon-jikhalsi, Republic of Korea
Background & Objective
Cerebral small vessel disease (cSVD) is a well-established contributor to intracerebral hemorrhage (ICH). Its presence carries enormous implications for stroke prevention, acute management, post-stroke recovery, recurrence, and socioeconomic burden. Despite its known clinical significance, how cSVD affects functional outcomes after ICH, especially in the context of aging, remains uncertain.
This study aimed to evaluate the impact of cSVD on functional recovery after ICH. To achieve this, we comprehensively assessed multiple functional domains and stratified patients by age (< 65 and ≥65 years) to control for age-related confounding effects.
Design:
We retrospectively analyzed 356 patients with primary spontaneous ICH. Functional status was evaluated at baseline and at 3 months post-ICH across multiple domains, including global disability, activities of daily living, gait, upper extremity function, and swallowing ability, using validated assessment tools. Patients were categorized by age and the presence or absence of cSVD.
Results:
Patients without cSVD consistently exhibited better functional status than those with cSVD at both the initial and 3-month after ICH evaluations across both age. Notably, although all groups—regardless of age or cSVD status—achieved statistically significant functional improvement over time, the degree of improvement was significantly lower in patients with cSVD, particularly among those aged 65 years or older
Multivariable logistic regression analysis confirmed that the presence of cSVD was a strong and independent predictor of poor functional outcomes at 3 months after ICH, even after adjusting for other variables.
Conclusion:
These insights may inform future research and clinical practice aimed at improving outcomes for ICH survivors with cSVD. The adverse impact of cSVD was especially pronounced in the elderly, indicating a need for age-specific post-ICH management. Routine screening for cSVD and individualized rehabilitation strategies may help optimize recovery in this high-risk population.
