• Cleusa P Ferri, Claudia Schoenborn, Lalit Kalra, Daisy Acosta, Mariella Guerra, Yueqin Huang, K S Jacob, Juan J Llibre Rodriguez, Aquiles Salas, Ana Luisa Sosa, Joseph D Williams, Zhaorui Liu, Tais Moriyama, Adolfo Valhuerdi, and Martin J Prince.
• King’s College London (Institute of Psychiatry), Health Service and Population Research Department, Section of Epidemiology, London, UK. cleusa.ferri@kcl.ac.uk
• J. Neurol. Neurosurg. Psychiatr. 2011 Oct 1; 82 (10): 107410821074-82.

ObjectivesDespite the growing importance of stroke in developing countries, little is known of stroke burden in survivors. The authors investigated the prevalence of self-reported stroke, stroke-related disability, dependence and care-giver strain in Latin America (LA), China and India.MethodsCross-sectional surveys were conducted on individuals aged 65+ (n=15 022) living in specified catchment areas. Self-reported stroke diagnosis, disability, care needs and care giver burden were assessed using a standardised protocol. For those reporting stroke, the correlates of disability, dependence and care-giver burden were estimated at each site using Poisson or linear regression, and combined meta-analytically.ResultsThe prevalence of self-reported stroke ranged between 6% and 9% across most LA sites and urban China, but was much lower in urban India (1.9%), and in rural sites in India (1.1%), China (1.6%) and Peru (2.7%). The proportion of stroke survivors needing care varied between 20% and 39% in LA sites but was higher in rural China (44%), urban China (54%) and rural India (73%). Comorbid dementia and depression were the main correlates of disability and dependence.ConclusionThe prevalence of stroke in urban LA and Chinese sites is nearly as high as in industrialised countries. High levels of disability and dependence in the other mainly rural and less-developed sites suggest underascertainment of less severe cases as one likely explanation for the lower prevalence in those settings. As the health transition proceeds, a further increase in numbers of older stroke survivors is to be anticipated. In addition to prevention, stroke rehabilitation and long-term care needs should be addressed.

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