Abstract / Summary
Frailty is common after stroke and changes over time, yet little is known about frailty trajectories from hospitalization to 12 months after discharge in older stroke survivors or the role of intrinsic capacity in shaping these trajectories. This study aimed to identify frailty trajectories from hospitalization to 12 months after discharge among hospitalized older adults with stroke and to examine how intrinsic capacity was associated with the identified trajectories. This prospective longitudinal study consecutively enrolled 314 older adults hospitalized for stroke in the Department of Neurology of the First Affiliated Hospital of Nanjing Medical University between April and December 2024. Baseline assessments were completed 48 h after admission and included demographic and clinical characteristics, stroke severity, comorbidity burden, perceived social support, and five domains of intrinsic capacity.Frailty was measured using the Fried Frailty Phenotype 48 h after admission and at 3, 6, and 12 months after discharge. Latent class growth modeling was used to identify frailty trajectories, and multinomial logistic regression was used to examine factors associated with the identified trajectory groups. A total of 293 participants completed follow-up (93.3%). The participants were aged 60–86 years, with a mean age of 68.97 ± 6.36 years.Three trajectories of total FFP scores were identified: low-decreasing (67.24%), moderate-stable (20.48%), and high-increasing (12.29%).Compared with the low-decreasing group, cognitive impairment (OR = 2.632, 95% CI: 1.263–5.488) and psychological impairment (OR = 3.671, 95% CI: 1.630–8.271) were associated with higher odds of belonging to the moderate-stable group.Normal/mild stroke was associated with lower odds of belonging to the high-increasing group than moderate/severe stroke (OR = 0.271, 95% CI: 0.095–0.773), whereas high comorbidity burden (OR = 3.801, 95% CI: 1.610–8.978), low or moderate social support (OR = 3.171, 95% CI: 1.310–7.672), cognitive impairment (OR = 4.506, 95% CI: 1.846–11.002), and psychological impairment (OR = 3.161, 95% CI: 1.123–8.900) were associated with higher odds of belonging to this group. Total FFP scores followed heterogeneous trajectories from hospitalization to 12 months after discharge in older stroke survivors.Cognitive and psychological impairments, high comorbidity burden, and insufficient social support were associated with unfavorable frailty trajectories. Early multidomain assessment may help geriatric nurses identify high-risk patients and tailor post-discharge monitoring and supportive care. Not applicable.