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    Classifying stroke recovery profiles based on living environment: A latent class analysis
    (SAGE Publications, 2025) Özgün, Mete; Akanyeti, Otar; Povina, F. Villagra; Rahman, R.; Saybaşılı, Hale; Atalar, Deniz
    Background and Aims: Post-stroke recovery is influenced by multiple factors including living environment. While skilled nursing homes may offer more comprehensive care, including physiotherapy, dietary support, and psychological counseling, many family caregivers remain concerned that such settings may lead to loneliness and a sense of abandonment in stroke survivors, which may negatively impact their recovery. This study investigates how different living environments influence functional and psychological outcomes. Methods: A total of 278 stroke survivors living either in their homes or nursing homes in Istanbul,Turkey were assessed. Patient outcomes were evaluated using Stroke Impact Scale, Stroke Specific Quality of Life Scale, Tampa Scale for Kinesiophobia, Geriatric Depression Scale, UCLA Loneliness Scale, and Tinetti Gait and Balance Test. Covariates included age, stroke years, education, medical history, treatments received and caregiver support. Results: Latent Class Analysis identified two distinct patient class, as shown in figure. Class 2 demonstrated significantly better outcomes char acterized by greater independence, improved quality of life, lower depres sion and loneliness scores, reduced kinesiophobia, lower fall risk, healthier exercise routines and sleep quality. While the overall sample included more individuals receiving home care, the class which exhibited better functional and psychological outcomes contained a higher proportion of nursing home residents. Results: Of the 382 patients, 78 were analyzed (31 stable/35 unstable plaques/12 acute occlusions). When analyzing early radiological changes, there was no significant difference between the three studied plaque types (p>0.05), while when monitoring early neurological changes (NIHSS), significant decrease in deficit was noted in stable (p=0.012) and unstable (p<0.001) plaques. A significant decrease in all groups was noted in late clinical changes (mRS, always p<0.001). However, no significant difference was found between studied plaque types and stroke severity (p>0.05) Conclusions: No significant association was found between carotid plaque morphology detected on CT and early/late stroke severity in carotid territory. Patients with stable plaques showed milder events and had better overall 3-month outcome.