Stroke is a major cause of activity limitations and is responsible for the third most disability-adjusted life years (DALYs) globally.1 Unlike the United States, stroke in China outpaces heart disease as the leading cause of mortality and morbidity.2 Furthermore, China’s ageing population means stroke’s impact will continue to grow and stress the public insurance system and families.3,4 The high prevalence of activity limitations among stroke survivors is well documented, with an estimated 25% to 74% requiring some assistance or fully dependent on caregivers for activities of daily living (ADL).5 Remaining to be quantified are differences in limitations between stroke patients and people living with other chronic conditions.

Studies have reported that the prevalence of stroke-related activity limitation increases substantially with age6 and varies with sex7 and some socioeconomic conditions.8,9 Social interaction and emotional support are suggested to be important to stroke prognosis, associated with faster and more extensive recovery of functional status.10 The associations between smoking,11,12 physical fitness,13 and blood pressure14 and functional dependency among stroke survivors are consistent across different populations. However, other behavioral and health indicators, such as alcohol assumption12,15 and Body Mass Index16,17 vary in their associations with stroke-related functional limitations. Moreover, the socio-economic and health situations that older Chinese face are not necessarily the same across different demographic characteristics.18,19 Among older Chinese stroke patients, up-to-date evidence on how their levels of activity limitation vary by age, sex, education, and other characteristics is needed to inform intervention strategies and policy options.

In this study, we seek to quantify the prevalence of activity limitations and severe activity limitations, measured using ADL and instrumental activities of daily living (IADL) scales, of Chinese 65 years or older who self-reported experiencing a stroke using data in the most recent (2017-2018) sample of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). We will compare them to their peers living with non-stroke chronic conditions and those who did not report living with a chronic illness. In addition, we will provide detailed analyses of the activity limitation profiles of older Chinese in our three exposure groups and stratified by different demographic characteristics, including age, sex, urban/rural residence, with/without formal school education, marital status, ethnicity, and living arrangement. We hypothesize that the prevalence of activity limitations and severe activity limitations would be higher among individuals who self-reported experiencing a stroke than either those who had a non-stroke chronic condition or those who did not have any chronic condition and that activity limitation would also be associated with sociodemographic and behavioral factors.